MAINE MUNICIPAL TAX COLLECTORS' & TREASURERS' ASSOCIATION APPLICATION FOR RE-CERTIFICATION Tax Collector:______Treasurer:______

Name: Title:

Municipality: County:

Population: Fiscal Year:

RE-CERTIFICATION

A. To be re-certified as a municipal Tax Collector or Treasurer, you must attend within five years of initial certification the 3 Annual Conferences, as well as participate in three professional and job-related classes-workshops-seminars sponsored by MMTCTA, the Maine Municipal Association, or other institution offering job-related programs. (Courses used for initial certification may not be counted for recertification -- unless you actually take the course again.)

B. Programs submitted under the course work at other institutions category other than the classes sponsored by MMTCTA or MMA must be job-related and provide an opportunity to enhance professional development (example: Technical College, Computer, Customer Service, Payroll, etc.). These programs are subject to approval by the MMTCTA Certification Committee.

C. Proof of successful completion and copy of initial certification must accompany completed application form.

D. Members may substitute their service as an instructor/trainer for one class/course requirement. MMTCTA Board members may use 1 year of service to fulfill the requirement for one optional course.

E. Applicant applying for re-certification must be working in the position of Treasurer or Tax Collector.

MANDATORY ATTENDANCE WITHIN 5 YEARS: 1. Tax Collectors & Treasurers Annual Conference (Must attend a minimum of three) 2. Three Programs or Course Work Name of Courses (Certificates or transcripts required) ____________________________________________ ____________________________________________ ____________________________________________

Date(s) Attended _________________________

The above information is correct as presented.

Signature: ________________________________________ Date: ___________________________________

FOR OFFICE USE ONLY

Date Received: ________________________________________________________________________________

Date Approved: ________________________________________________________________________________

Date Cert. Sent: ________________________________________________________________________________

Associate Certificate Treasurer’s Certificate Tax Collector’s Certificate