The following forms may be downloaded, viewed and printed. Please be sure to follow the directions included on each form to assure that all required information is filled out before the form is submitted.

If you have trouble loading the forms, please email Michelle Jenkins at mjenkins@neiwpcc.org or call (978) 349-2516.

Massachusetts Title 5 Training Contact Hour (TCH) Approval Requests:

Training providers seeking approval of Training Contact Hours (TCHs) for Massachusetts Title 5 System Inspectors and/or Soil Evaluators must submit a completed application packet for each individual course or training session.

There is no fee to request TCH approval.

Application Requirements

Each application packet must include:

  1. Completed Request for TCH Approval form – All applicable fields must be completed.
  2. Course outline or agenda – A description of the training topics and content covered.
  3. Course materials – A list or representative samples of the instructional materials, such as presentations or handouts.
  4. Speaker biographies – Background information demonstrating the qualifications of each instructor or presenter.

Submission Instructions

  • Submit one complete application packet per course.
  • Combine the completed application form and all supporting documentation into a single PDF file for each course.
  • Email the completed PDF application packet(s) to title5@neiwpcc.org.
  • Please do not submit supporting information separately in email messages or as multiple attachments.

Review and Approval Process

Complete applications are forwarded to the Onsite Advisory Committee for review and approval. The review process typically takes approximately two weeks.

Applications may be submitted before or after a training session takes place. However, training providers may not advertise TCHs as approved until they receive written confirmation of approval from NEIWPCC. Until then, TCHs may be advertised as pending approval.

Incomplete applications may be returned to the training provider for completion before being submitted for review.

Form for pre-approved candidates to become System Inspectors (not used for the class):

🚫 Do NOT submit this form if you are not in one of the categories listed below.
🚫 This form is NOT a registration for the MA Title 5 System Inspector course.

Massachusetts Registered Professional Engineers (civil, sanitary and environmental), Certified Health Officers, and Registered Sanitarians are not required to take the course and examination in order to become certified MA Title 5 System Inspectors, but must submit an application fee of $100 (payable to NEIWPCC) along with this (completed) form and proof of eligibility.

Form to change Active/Inactive status on Title 5 approvals:

In order to change from INACTIVE to ACTIVE status, the applicant must provide evidence of having obtained 10 training contact hours of approved training, within the current calendar year.

Please complete and submit this form to NEIWPCC at the address above in order to change the status of your Title 5 system inspector or soil evaluator approval. There is a $25 administrative fee (made payable to NEIWPCC) that must be submitted along with a completed status change form.

Form to get a reprint of wall certificate or wallet card:

Renewal forms for first-time renewals only:

All other renewals (renewals with June 30th expiration date) are issued an individual invoice. These invoices are mailed out in March and again in May of the renewal year. If you need a copy, please email title5@neiwpcc.org and include your SE and/or SI certification number and another copy will be emailed to you.