CWI/SCWI Renewal Application Page 1 of 2 Ver: February 2, 2014

AWS RENEWAL APPLICATION FOR WELDING INSPECTOR International (CWI/SCWI)

2. Check one of the following

MAIL MY CREDENTIALS TO ME BY REGULAR SERVICE: Mailing Address below.

MAIL MY RENEWAL CERTIFICATE, CARD AND STAMP TO AGENT:

Last Name

First Name

Mailing Address

Address Cont’d Apt #

City, Province /State , Country Postal code or ZIP

Date of Birth mm/dd/yy

Home Telephone Number

Work Telephone Number

Electronic Mail (e-mail Required )

4. Current Job

1. Check only one (1) of the following and print your Cert.# and AWS#

Renewal by work experience (CWI/SCWI)

Applicants who meet the requirements of 6.2.2 of AWS QC1, but did not meet the experience requirements of 5.2.2 of AWS B5.1 may request an upgrade to the CWI level once the experience requirements are met.

YOUR CERTIFICATION NUMBER: ________________________ AWSMEMYOUR AWS MEMBER NUMBER:______________________

3. Method of Payment: Payment must accompany your application

*All checks, D.D. and money orders payable to: American Welding Society*All checks, Demand Drafts and money orders must be drawn against banks in U.S.A. and payable in American Dollars.

Payment made directly to AWS.

Payment made to an AWS Agent:______________________________

Check or Money Order #_____________________

Bank Transfer- Proof of payment must be attached to application VISA MC Discover

Expiration Date (mm/yy)

Authorized Signature

AWS USE ONLY

Date:

Acct: #

Amt: $

Type of Business (check only ONE)

A Contract construction

B Chemicals & allied products

C Petroleum & coal industries

D Primary metal industries

E Fabricated metal products

F Machinery except elect. (incl. gas welding)

G Electrical equip., supplies, electrodes

H Transportation equip. - air, aerospace

I Transportation equip. - automotive

J Transportation equip. - boats, ships

K Transportation equip. - railroad

L Utilities

M Welding distributors & retail trade

N Misc. repair services ( incl. welding shops)

O Educational Services (univ., libraries, schools)

P Engineering & architectural services (incl. assns.)

Q Misc. business services ( incl. commercial labs)

R Government (federal, state, local)

S Other

Job Classification (check only ONE)

01 President, owner, partner, officer 02 Manager, director, superintendent (or assistant) 03 Sales 04 Purchasing 05 Engineer — welding 06 Engineer — other 07 Inspector, tester 08 Supervisor, foreman 09 Welder, welding or cutting operator 10 Architect, designer 11 Consultant 12 Metallurgist 13 Research & development 14 Technician 15 Educator 16 Student 17 Librarian 18 Customer service 19 Other 20 Engineer - design 21 Engineer - manufacturing 22 Quality Control

Ferrous metals Aluminum Non-ferrous except aluminum Advanced materials/intermetallics Ceramics High energy Processes Arc Welding Brazing & Soldering Resistance Welding Thermal Spray Cutting NDT Safety & Health Pipe & Tubing

Pressure Vessels & Tanks Structures Roll Forming Sheet metal Stamping & punching Bending & shearing Aerospace Automotive Machinery Marine Other Automation Robotics Computerization of Welding

This application may be submitted directly to AWS or to an AWS International Agent: http://www.aws.org/w/a/certification/inter_contact.html

Technical Interests (check ALL that apply)

Upgrade (CAWI only)

MAIL MY CREDENTIALS BY COURIER SERVICE. I am willing to pay an additional shipping cost of USD $60 for the Courier Service. Please ship my documents by certified mail via courier to my postal address as it appears below.

AWS may send a renewal notice, but if not received, it remains the responsibility of the SCWI/CWI to renew on time.

Mobile Telephone Number

Renewal/Upgrade Fees: http://www.aws.org/certification/docs/pricelist.pdf

Mail to: 8669 NW 36 St., Suite 130 Miami, FL 33166, U.S.A.Telephone: (1) 305 443-9353

AMEX Diners Credit Card Number (c.c. #)

Security Code PI(CSC, CVV, CV2, CVC, CCV)

NAME Certificate #

CWI/SCWI Renewal Application Page 2 of 2 Ver: February 2, 2014

5. Qualifying Work Experience

Requirements: (PLEASE REFER TO AWS QC1, STANDARD FOR AWS CERTIFICATION OF WELDING INSPECTORS FOR FURTHER DETAILS)

- The period of validity for AWS SCWI or CWI certification is three (3) years. The SCWI/CWI shall be responsible for maintaining acurrent address with the AWS Certification Department. To be eligible for renewal, the CWI must:

o Submit an approved renewal application to the AWS Certification Department by the expiration date of thecurrent certification and no earlier than 6 months prior to the expiration date of that certification.

o Submit an updated Visual Acuity Record. http://www.aws.org/certification/docs/VisualAcuityRecord.pdf

The SCWI/CWI requesting renewal of certification shall attest to having no period of continuous inactivity greater than two years in activities described in AWS B5.1 and QC1 during the previous three years of certification. SCWI/CWI not meeting the requirements of 15.4 from AWS QC1 may renew by taking the CWI part B Practical exam and meet the scoring requirements of 6.2.2 of QC1.

6. Testimonial (Applicants must read and sign the following statement in front of a Notary or their Authorized International Agent)

I hereby certify that I have read the standard requirements contained in AWS QC1, Standard for AWS Certification of Welding Inspectors. Further, I agree to comply with the existing requirements and any subsequent requirements instituted by AWS. I have read and agree to the terms and conditions set forth in the AWS Policies and Fees form. I certify that the information I have included on this application is true. I understand that any false statements will nullify this application. I give AWS permission to verify this information. I agree to comply with the provisions set forth in the Standard concerning the administration of my examination and certification. Upon obtaining my certification, I give AWS the right to reveal my certification status as it relates to my validity and expiration date only. I further understand that any required information that is incomplete or missing will cancel this registration. Further, I agree to comply with the existing requirements and any subsequent requirements instituted by AWS. I have read and agree to the terms and conditions set forth by AWS, its Policies and Fees. Furthermore, I certify that I have complied with the Requirements, Code of Ethics, Rules of Conduct, and Practice; following the guidelines given by the AWS.

I understand that a violation of this oath may be grounds for the invalidation of my certification.

Date:

day of the year

Applicant’s Signature

Sworn to and subscribed before me this

Company Name Type of Business Company Phone Number

Company Street Address City, State, Country, Postal Code

Supervisor’s Name Title of Immediate Supervisor

Supervisor’s Email Address Department

Applicant’s Job Title Employed From:

(Mo.) (Yr.)

To:

(Mo.) (Yr.)

Job Responsibilities- Detailed Description Required*

NOTARY SEAL or AUTHORIZED INTERNATIONAL AGENT STAMP

COMPANY SEAL of CANDIDATE's CURRENT EMPLOYER

Notary Public’s Name

Notary Public’s SignatureMy commission expires on:

ATTACH A LETTER FROM YOUR MOST RECENT EMPLOYER ON COMPANY LETTERHEAD CERTIFYING YOUR TIME EMPLOYED, FUNCTIONS, AND JOB TITLE HELD. IF CURRENTLY SELF-EMPLOYED OR A CONTRACT APPLICANT YOU MUST SUBSTITUTE THIS SECTION WITH A LETTER OF REFERENCE ON COMPANY LETTERHEAD FROM TWO (2) SEPARATE CLIENTS ATTESTING TO THE NATURE OF WORK ASSIGNMENTS DURING THE PERIOD OF PERFORMANCE, TYPE OF WORK DONE AND LENGTH OF TIME AS A CLIENT.

The letter shall certify: applicant’s full name, job title, start/final date (employment dates), company name, company address and telephone number, immediate supervisor’s name, and the name and title of the person completing the letter. That letter must be signed and seal/stamped by a company representative and must be written in English. http://www.aws.org/certification/docs/QC1-2007.pdf

Note: A 9 year re-certification differs from a 3 or 6 year CWI renewal by work experience. If you wish to apply for a 9-year CWI Re-certification, the correct form can be found here: http://www.aws.org/certification/9year/

(PLEASE REPRODUCE THIS SECTION AS NECESSARY TO RECORD YOUR WORK EXPERIENCE)

____________________________________________________________________ ___________

o Submit a current photography (2"x2" or 51x51mm). http://www.aws.org/w/a/certification/photoidreqs.html