Hire a BAT List Authorization Form

I authorize Washington Certification Services at Green River College to publish my name and contact phone number on a public listing of Backflow Assembly Testers certified in Washington.

Add my name to the Hire a BAT List.
Change my existing information on the Hire a BAT List.

* Required

Name *:

BAT Cert. # *:

Verification of Address on File at Washington Certification Services
Please note that your address will NOT be published on the Hire a BAT List. Verification of home mailing address is for identification information only:

Address *:

City *:

State *:

Zip Code *:

Contact Phone Number (will be listed on the Hire a BAT list) *:

Email :

This listing is restricted to ONE county selection. Please select your choice from the list below.

-- Please select one -- Adams Asotin Benton Chelan Clallam Clark Columbia Cowlitz Douglas Ferry Franklim Garfield Grant Garys Harbor Island Jefferson King Kitsap Kittitas Klickitat Lewis Lincoln Mason Okanogan Pacific Pend Oreille Pierce San Juan Skagit Skamania Snohomish Spokane Stevens Thurston Wahkiakum Walla Walla Whatcom Whitman Yakima