Member Login
 
   
Overview >
General Information  
Study Aides  
Register Now!  
     
 
   
   
     
   


Overview

CERTIFIED AUTO GLASS REPAIR TECHNICIAN REGISTRATION FORM
* An asterisk designates a required field

Applicant Information

* First Name * Last Name
* Social Security #  (last four digits only)   Member #
* Address      
* City/ Province      
* State   Country
* Zip/Postal Code      
Email      

Company Information
* Company    
* Address    
* City/ Province    
* State Country
* Zip/Postal Code    
* Phone No.    
Fax No.    


Provide the month and year you began working in the Auto Glass Repair Industry and the number of Auto Glass Repairs you have personally completed:
Month Year Number of Repairs

OR

Provide the name of the Auto Glass Repair training program you have successfully completed and the number of Auto Glass Repairs you have personally completed:
 
Training Number of Repairs

Checklist

Please read the following checklist, and check off each point as you understand it.
Certified Auto Glass Repair Technician Level
(A) Diagnose and document vehicle glass damage.
(B) Inspect vehicle and identify ALL repairable glass damage.
(C) Practice personal safety.
(D) Working knowledge of applicable OSHA, FMVSS, and ROLAGS requirements.
(E) Perform repair on ALL types of breaks.
(F) Use and maintain, repair systems, accessories, supplies and resins.

On Site Exam Fee
$134.95 for NGA Members $164.95 for Non-Members

Online Exam Fee (check only if you wish to take the exam via the Internet)

Auto Glass Repair Technician
$99.00 for NGA Members $129.00 for Non-Members

Auto Glass Repair Technician & Reference Manual
$123 for NGA Members $189.00 for Non-Members

If you would like to save money and purchase the reference manual now, please check here:
$29.00 for NGA Members* $84.00 for Non-Members*

*Special price when purchased with certification registration. Standard price: NGA Member $34.95; Non-Member $69.90.

> Special price of $99.00 for MyGlassClass.com subscribers only!!!
Please contact Miguel Rodriguez at 703/442-4890 ext. 130 for more information!

Payment

NOTE: To complete online registration, credit card is the only form of payment accepted. After filling out the form, click on the submit button and your information will be submitted by way of secure web server.
To pay by check:(Made payable to NGA) Press Ctrl-P or File-Print to print out this page on your local printer and mail to NGA with payment. NGA, 8200 Greensboro Dr., Ste 302, McLean, VA 22102, USA. Note: No need to press the "Submit" button if mailing in the form. Non-U.S. organizations must make payment with a credit card or a draft on a U.S. bank. This draft can be purchased at a bank in your area.

Subtotal:
Shipping:
Total:

Type of Card Visa MC AMEX
Card Number
Expiration Date
Name on the Card

* In lieu of a signature, please fill in your birth month and day (year not needed). 


Policy Statement    

I hereby apply for the NGA Certified Auto Glass Repair Technician Program and understand that certification depends on successful completion of specified requirements. I further understand that the information for my certification records will be treated confidentially, that the information provided by me or accrued in the certification process also may be used for statistical purposes, for evaluation of the certification program, and for verification purposes by potential and current employers and insurance companies, in accordance with standard NGA policies and procedures. To the best of my knowledge, the information contained in this application is true, complete, correct, and is made in good faith. I understand that NGA reserves the right to verify any or all information on this application and that any incorrect or misleading information or other actions compromising the certification and examination process may constitute grounds for revocation of my certification or other disciplinary action. I have read the terms of the policy statement.