Request Renewal of CGW Credential
Instructions

Instructions

This form can be submitted no earlier than 6 months prior to the expiration of the current CGW credential.

This form can be submitted no later than the last day of the one-year grace period.
1. Name

1. Name

Provide name (as you want printed on your renewal certificate)
Mailing Address

Mailing Address

Provide the mailing address for your CGW renewal certificate

E-mail address

E-mail address

Provide your current e-mail address
Expiration date of most recent credential

Expiration date of most recent credential

Provide the expiration date on the most recent CGW credential.
2. List of activities earning CGW Renewal Credits

2. List of activities earning CGW Renewal Credits

List the activities with the number of CGW Renewal Credits earned.

Verifier

Verifier

For security purposes, we ask that you enter the security code that is shown in the graphic. Please enter the code exactly as it is shown in the graphic.
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