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REGISTRATION FORM

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Please provide the following information to register for access to CARB’s “Tester Training for California’s Heavy-Duty Inspection and Maintenance Program” and to take the exam to become a Credentialed HD I/M Tester.

First Name Este campo es obligatorio.

Please enter your First Name

Last Name Este campo es obligatorio.

Please enter your Last Name

Dirección de correo electrónico Este campo es obligatorio.

Please provide a valid email address. All emails sent from the HD I/M Tester Training Course and Exam system will be sent to the email address you provide.

Nombre de usuario Este campo es obligatorio.

Varios caracteres están permitidos, incluyendo los espacios, puntos (.), guiones (-), comillas ('), guiones bajos (_) y el signo @.

Contraseña Este campo es obligatorio.

Confirmar contraseña Este campo es obligatorio.

Proporcione una contraseña para la cuenta nueva en ambos campos.

Credentialed HD I/M Tester List

Please check this box if you want your name and contact information to appear on CARB’s list of Credentialed HD I/M Testers made available to the public. CARB recommends you make your information available if you want to offer for-hire HD I/M testing services to fleet and vehicle owners.

Phone number Este campo es obligatorio.

Please format phone number as: XXX-XXX-XXXX

Name of Business

Physical Address Este campo es obligatorio.

Please format physical address as: Street Number and Street Name, City, State, Zip Code. Example: 1001 Apple Street, Sacramento, CA 95814.

Is your physical address same as your mailing address?

Mailing address

Please format mailing address, if different than physical address, as: Street Number and Street Name, City, State, Zip Code. Example: 1001 Apple Street, Sacramento, CA 95814.

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