Asnt Ndt 2 App

7/28/2019 Asnt Ndt 2 App

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NDT-II app 1 of 8 Rev. 10/29/10

ASNT NDT Level IICertification Application

ASNT Identification NumberIf you have previously been given an ASNT identification number, please enter it in this box:

Personal Data Mail certification information to: Home WorkMail membership material to: Home Work ___Mr ___Miss ___Mrs ___MsName

Last First Middle Init.

HomeAddress

City State/Prov. ZIP/Postal Code Country

Phone Fax Email

WorkOrganization Name

Address


Phone Fax Email

FeesAll fees are in US dollars.

Examination Total From page 2 $

International Mailing Surcharge All non-US Residents must pay a $40.00 mailing surcharge $

Membership OptionTake advantage of ASNT member pricing now by completing themembership application on pages 7 and 8 and include that total here. $

Save on certification fees by becoming an ASNT member.See page 7 for all the benefits members enjoy.

Total Fees $

Less transfer in (if applicable-include copy of transfer letter)

-$

Total Due $

PaymentPayment must accompany application Personal Credit Card Company Credit Card

Check

Money Order

Discover

Visa Card Holders Signature:

Funds Transfer MasterCard Card Holders Name (print):

Make the abovepayable to ASNT

(must be drawnon a US bank)

American Express Credit Card Number:

Credit Card Billing Address:

Expiration Date CIN* Number

*CIN (Credit Card Identification Number): Visa/MasterCard/Discover: The three-digit number is printed on the signature panel on the back othe card following the account number. American Express: The four-digit number is printedabove the account number on the front of the card


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Examination InformationLocation and Dates

Select a location from the online ASNT Examination Schedule (http://www.asnt.org/certification/schedules/index.htm) and enter thelocation of the exam here. You may also choose to take your examination(s) at one ofASNTS Authorized Examination Centers (AECs) or National Sponsoring Organizations(NSOs). If you are applying to take your examination at one of those sites, enter AEC orthe NSO site where you wish to examine. AECs and NSOs Centers charge additionaladministration fees; check with those organizations to learn those fees.

Scheduling and Fees, Initial CertificationASNT NDT Level II candidates applying for initial certificationMUST take both the General examination AND a General IndustrySpecific examination OR a Pressure Equipment Specific examination for each test method in which certification is sought.Candidates have the option of taking both Industry Sector Specific examinations if they wish to be certified in both Industry Sectors.

In the table below, check the boxes for the examinations you wish to take, enter the dates and times when you wish to take thosexaminations and place the appropriate fee amount in the "Your Fees" column. When finished, total your fees and place them in thFees column on page 1 of the application.

Example:

An ASNT member wishing to be certified in MT in the Pressure Equipment Sector at an AEC would fill out the MT line as follows:

Method Examinations RequestedASNT Member

Exam FeeNon-Member*

Exam FeeExamDate

Exam Time(AM or PM)

Your Fees

MT General + PE Specific Exams $260.00 $335.00 AEC $260.00

Exam dates are listed in the ASNT Examination Schedule shown online at http://www.asnt.org/certification/schedules/index.htmExaminations for only one test method may be taken in each morning or afternoon session, with a maximum of two (2) examinationper day at a scheduled test site. If you are applying to take your examination at an AEC, write AEC under Date. You will theschedule the date and time of your examination directly with the AEC after you receive your Notification of Approval letter from ASNT.


Exam FeeNon-Member*

Exam FeeExamDate

Exam Time(AM or PM)

Your Fees

MT

General + GI Specific Exams $260.00 $335.00 $

General + PE Specific Exams $260.00 $335.00 $General + GI & PE Specific Exams $390.00 $465.00 $

PT

General + GI Specific Exams $260.00 $335.00 $General + PE Specific Exams $260.00 $335.00 $

General + GI & PE Specific Exams $390.00 $465.00 $

RT General + GI Specific Exams $260.00 $335.00 $General + PE Specific Exams $260.00 $335.00 $General + GI & PE Specific Exams $390.00 $465.00 $

UT



VT



Your Fee Total: $

(Place this amount in the Exam Fees block on page 1)

Retakes and Industry Sector Add-Ons

Personnel retaking failed examinations or adding an Industry Sector should select their examinations from the table below. Initialcertification candidates may NOTuse this table; they should use the table above.


Exam FeeNon-Member*

Exam FeeExamDate

Exam Time(AM or PM)

Your Fees

MT General Specific: GI PE $130.00/exam $205.00/exam $

PT General Specific: GI PE $130.00/exam $205.00/exam $

RT General Specific: GI PE $130.00/exam $205.00/exam $

UT General Specific: GI PE $130.00/exam $205.00/exam $

VT General Specific: GI PE $130.00/exam $205.00/exam $

Your Fee Total: $

(Place this amount in the Exam Fees block on page 1)

* You may take advantage of ASNT Member pricing now by becoming an ASNT member or renewing yourmembership with this application. An ASNT Membership application is attached on pages 7 & 8 of this application.

Location:


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Experience

Photocopy this page as necessary to list your experience history. If submitting experience from more than oneemployer, submit experience in reverse chronological order, beginning with your most recent employer in Position 1. TheASNT NDT Level II program requires sufficient NDT experience to meet the minimum experience requirements in themethod(s) for which you are applying. Acceptable documents include employer or third-party certificates or certificationrecords, human resources records, a signed statement from the employer or responsible Level III, a signed statemenfrom an ASNT Level III or ACCP Professional Level III, or, for self-employed personnel, signed statements from at leasttwo (2) customers. The signature form below may be used for signed statements. All support documentation must be inEnglish or accompanied by an English translation.

NameFirst, Middle, Last ASNT ID

Position # _____ Dates of Employment:Start Date End Date Total Time (Months)

Organization Name

Organization Address


Phone Fax Email

Check methods below where NDT job functions were performed by the candidate named above and indicate the numberof hours claimed for each.

MT PT RT UT VT

Hours Hours Hours Hours Hours

Briefly describe below the NDT tasks the candidate named above performed at this location for each of the methodschecked. List the document(s) that are attached to this application as evidence of this engagement.

Statement Option

As the above named candidates employer or a designated and responsible agent of the above named candidatesemployer or as a customer of the candidate, I confirm that the information given above is true and correct.

Employer/Agent/Customer Signature Date

Employer/Agent/Customer Name (print) ASNT ID # (if applicable)

Title


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Code of Ethics for NDT Level II Personnel Certified by ASNT1.0 Purpose

The following Code of Ethics is binding upon every individual whopossesses a current ACCP or ASNT NDT Level II Certification.These rules are necessary to protect the life, health, property andwelfare of the public, and to maintain the credibility of the ASNTCentral Certification Program, the ASNT NDT Level II program andthe NDT profession. Accordingly, each ACCP or ASNT NDTLevel II certified individual agrees to abide by the following:

2.0 Code of Ethics

2.1 Responsibility: Protect the safety, health and welfare of the public,by performing all NDT activities to the best of his/her ability inaccordance with properly established and approved procedures andonly in situations for which qualified.

2.2 Integrity: Perform all NDT activities honestly, and treat the public,clients and employer in an impartial and ethical manner. All reports

of NDT activities shall faithfully and accurately reflect the testsconducted, procedures used, and results obtained.

2.3 Conflict of Interest: Consciously avoid conflict of interest situationswith employer or client, promptly informing same if such situationscannot be avoided.

2.4 Improper Conduct: Refrain from work activities outside the area ocertification without written approval of his/her supervisor.

2.5 Safety: Act in a safe and responsible manner while conducting

NDT activities, ensuring that all required and necessary safetyprocedures are in place and are being used by ones self and othersunder his/her jurisdiction.

3.0 Penalty

Violation of this Code of Ethics by any ACCP or ASNT NDT LeveII certificate holder may be cause for disciplinary action against thaperson which may result in sanctions up to revocation of ASNTcertification.

Statements and SignatureBy signature on this application, if certified by ASNT, I agree toabide by the Code of Ethics for Level II Personnel Certified by

ASNT so long as I maintain a Certificate. Further, I understandthe right of ASNT to suspend or revoke any Certificate granted ifI abuse the privileges therein granted to me.

I understand that certifications which may result from thisapplication do not constitute any form of license.

I hereby attest that all facts on this application are true andcorrect and no information which might be detrimental has beenwithheld. ASNT may make any inquiries necessary to determinemy qualifications for certification. I agree to abide by the decisionof ASNT relative to the granting of any Certifications as appliedfor herein.

For valuable consideration, the undersigned, having madeapplication for Certification as Level III before ASNT, does

hereby release and forever discharge The American Society ForNondestructive Testing, an Ohio Corporation, from any and allliabilities, claims, demands, or causes of action whatsoever,which now exist or which may hereafter arise on account of theundersigneds activities henceforth as Level III certified by ASNT.

The undersigned further acknowledges that this release is beingiven as a prerequisite for having filed application fo

consideration by ASNT.The undersigned further represents that if not certified by ASNTthen this release and discharge shall have no force and effecotherwise, upon certification as set forth above, this release shabe binding on the undersigned and The American Society foNondestructive Testing, Inc. and any and all agents of ASNT iconnection with such certification process. I have read andunderstand the attached transfer, cancellation and refund policand understand that all application documents submitted tASNT become the property of ASNT.

I authorize ASNT to publish my name, city, state, country, tesmethods, Levels and expiration dates of certification.

Signature of Applicant

Print Name of Applicant

Date

Transfer / Cancellation / Refund Policy

All ASNT examinations are required to be taken within onecalendar year from the date on the original Letter of Notificationor Letter of Approval sent to the applicant. One transfer ispermitted within that year, subject to the administrative feesdetailed below. Failure to take examinations within that one-year

period will result in forfeiture of all fees to ASNT.

The transfer or cancellation deadline is two (2) calendar weeksprior to the week of a scheduled examination. Transfers orcancellations received before the deadline will be subject to a$75.00 administrative fee PER EXAMINATION. A transferringapplicant must remit those administrative fees to ASNT by theapplication deadline for the rescheduled examination. Noexamination attendance will be permitted unless all fees arepaid. Canceling applicants will receive a refund less alladministrative fees.

No transfers or cancellations will be accepted after the abovetransfer deadline. Failure to show up (No Shows) for scheduledexaminations will result in forfeiture of the fees for the misseexaminations.

If an examination application is received and the applicant ifound to be unqualified to take the examination, a refund will bissued less an administrative fee of $75.00 PER EXAMINATION

All requests for transfers or cancellations must be submitted iwriting to ASNT and be signed by the person registered for thexamination. A signed fax transmittal is acceptable.

The International Surcharge and Membership / AdministrativeFees are non-refundable and non-transferable.

No exceptions will be made to the above policy.


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Submit Application

Mail

Mail this application, attachments, and fees to ASNT at:

ASNT1711 Arlingate LaneP.O. Box 28518Columbus, OH 43228-0518USA

Make checks payable to ASNT.Fax

Or, if paying by credit card, you may fax this application,attachments, and fees to ASNT at:

614-274-6899

*** Please do not both mail and fax your application.***


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Membership app Page 7 of 8 Rev. 10/29/10

ASNT Individual Membership Application & Renewal Form

Member Information

Last Name First Name M.I. Phone

Send Membership Materials to: Home Office Former Member: Yes No

Join now for immediate and significant savings on

examination fees. Save $75 per method.

Earn recertification points for ASNT membership.

Align with your certification period and consider joiningfor five years to receive maximum savings.

There is no better network for you to be connected when itcomes to your NDT career.

Stay informed throughout your certification period bymaintaining membership along with your certification.

ASNT membership keeps you informed of the latest intechnology in addition to savings on certification exams.

ASNT membership includes: 25% discount on all items purchased from ourPublications Catalog or Shop ASNT online at www.asnt.org

Membership OptionsRenewal Member DuesTo qualify to pay as a renewing member, your membership expiration date must

be within six months.

Access to the largest network of NDT contacts and businesses

worldwide

Materials Evaluation, the authoritative monthly journal on NDT

Local Section affiliation, provides educational and businessnetworking opportunities

The quarterly newsletter for NDT practitioners:

The NDT Technician

Recertification points for membership

Discounts on national conferences and symposiumregistration

Members Only access at www.asnt.org provides publicationsand networking functions

Serve on ASNT committees; be part of a group that may effectchange or the industry

Become part of the foremost nondestructive testinsociety and be fully connected to the NDT world.

New Member DuesNew members are those joining ASNT for the first time or members having more thasix month gap since expiration. Such rejoining members are subject to new member

Renewal Member

Dues *Dues with AirmailService included

*New MemberDues

*Dues with AirmailService included

Dues include subscriptions Materials EvaluationandThe NDT Technician.

For members outsideNorth America: Unless airm

is specified, all materials will bsent sea/surface mail; allow 3months for delivery.

*Airmail service is restricted availability or cost; airmail mnot be offered to your countrYou will be contacted if servicannot be provided.

One-Year $65 $113 $75 $123Two-Year $125 $209 $135 $219Three-Year $180 $294 $190 $304Five-Year $290 $465 $300 $475Student, One-YearMust submit transcript or letter or enrollment $15 $63 $15 $63Military Rank E-5 or lower $30 $78 $30 $78All pricing subject to change. New member dues include a one-time $10 administration fee

Dues are nonrefundable, nontransferable. Dues include subscription to Materials Evaluation and The NDT Technician.

Research in Nondestructive Evaluation (RNDE) Individual Subscription

RNDEis ASNTs quarterly research journal.With AirmailService Included

Print Subscription - for current volume $55 $129 Add a subscription to ASNTquarterly research journal,RNDE.

Electronic Subscription - for current volume $55Print and Electronic Subscription - a savings of $35 $75 $149All pricing subject to change.

Total Membership Amount $

Please enter total amount in membership box on page one and add to total.

Be sure to complete the questions on the next page.


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Documents

Asnt Ndt 2 App