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Apply online for a new Backflow Prevention Tester’s Licence ($50.00)
New Backflow Prevention Tester’s Licence
$50.00
To apply for this licence, enter the required information below and click "Proceed to Checkout".
Required fields
Applicant
First name
Middle name
Last name
Date of Birth
Email
Phone (Primary)
Phone (Alternate)
Mailing Address
Please enter your postal code to begin
PO Box
PO Box
Country
Canada
United States of America
Postal code
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Zip Code
Province
Aberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
State
Maine
City
City
Street Number
Civic number suffix
Street name
Street name
Unit type
N/A
Apartment
Suite
Unit
Room
Unit
Certificate Details
NB Certificate of Qualification Number (C of Q)
Date issued
Trade
Upload NB Certificate of Qualification (C of Q)
Certificate Uploads
Upload Backflow Prevention Tester’s Certificate
Upload Equipment Calibration Certificate
Signature of Applicant
Signature
Checking this box is the same as providing your signature
I understand and agree
Checking this box and electronically sending this form constitutes your electronic signature.
Date
2024-09-18 [20240917.3 (45862)]
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