2. PLEASE CHECK AND COMPLETE THE FOLLOWING: 3. PLEASE SELECT THE FOLLOWING FOR YOUR BETA EXAM: 4. METHOD OF PAYMENT AWS USE ONLY

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1 8669 NW 36 St, #130, Miami, FL (800) , ext. 273 Fax: (305) CRWT (Certified Resistance Welding Technician) EXAM APPLICATION BETA TEST LAST NAME FIRST NAME MI ADDRESS APT NO. CITY AND STATE / PROVINCE / COUNTRY ZIP CODE HOME TELEPHONE NUMBER WORK TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER ADDRESS 1. PLEASE INDICATE THE EXAM LOCATION OF YOUR CHOICE: Site Code:GA73414 Exam Date: November 13, 2014 City/State: Atlanta, GA/Fabtech *Submission Deadline: October 27th, PLEASE CHECK AND COMPLETE THE FOLLOWING: 3. PLEASE SELECT THE FOLLOWING FOR YOUR BETA EXAM: CERTIFICATION STATUS CAWI CWI CWE SCWI CRI CRAW CWSR None CRWT BETA EXAMINATION CERTIFICATION NUMBER (if applicable): YOUR AWS MEMBERSHIP # CLOSED BOOK FORMAT 4. METHOD OF PAYMENT AWS USE ONLY Special Beta Test No Charge Acct #: Date: Amt$: _0.00 CRWT Beta Exam Rev. 9/11/2014 Page 1 of 5

2 5. EDUCATION AND WORK EXPERIENCE REF.: AWS C1.5:2009, SEC. (6) AWS QC20:2011, SEC. (6) OFFICIAL TRANSCRIPT SUBMITTED A. Successfully completed high school or obtained a GED and have a minimum one (1) year of related work experience. B. Successfully completed high school or obtained a GED and have successfully completed a post high school program and have a minimum six (6) months of related work experience. Note: For documentation of partial completion or graduation from a state accredited high school, trade or technical school, college, or university, an official transcript shall be forwarded directly to the AWS Certification Department by the issuing school or agency. Photostat copies of transcripts shall not be used to determine eligibility for certification. Official documentation supporting the highest level of education being claimed must be forwarded. Ref. QC20:2011. The official transcripts may be provided following the beta exam, but exam results cannot be released without this document on file at AWS. 6. QUALIFYING WORK EXPERIENCE: RESUMES NOT ACCEPTED. THIS SECTION MUST BE COMPLETED. NOTE: PLEASE DUPLICATE THIS SECTION FOR EACH ADDITIONAL EMPLOYER IN ORDER TO MEET THE QUALIFYING WORK EXPERIENCE REQUIREMENTS FOR CRWT ELIGIBILITY. TYPES OF EXPERIENCE Manufacturing. Each individual seeking qualification shall have experience consisting of the design, application, or operation of welding lines or cells for the manufacture of welded products such as automobiles, appliances, wire products, sheet metal products, or other resistance welded products. Fabrication. Each individual seeking qualification shall have experience consisting of the design, application, or operation of welding facilities that fabricate welded products. Fabricated products may be covered by national, customer, or internal standards or specifications. Research and Development. Each individual seeking qualification shall have experience consisting of research and development to enhance welded products or processes, welding materials, manufacturing, fabrication, or the design of welding manufacturing systems. Training. Each individual seeking qualification shall have experience consisting of instructing courses in various resistance welding topics or related technologies. CRWT Beta Exam Rev. 9/11/2014 Page 2 of 5

3 6. Work Experience (Continued) I understand that all work experience documented on this application may be verified with (initials) both past and present employers. Types of experience required are listed at the beginning of section 6 of this application. Company Name Type of Business Company Phone Number Company Street Address City, State, Zip Code Supervisor s Name Supervisor s Address Title of Immediate Supervisor Department Applicant s Job Title Employed From: To: Job Responsibilities- Detailed Description Required* Company Name Type of Business Company Phone Number Company Street Address City, State, Zip Code Supervisor s Name Supervisor s Address Title of Immediate Supervisor Department Applicant s Job Title Employed From: To: Job Responsibilities- Detailed Description Required* CRWT Beta Exam Rev. 9/11/2014 Page 3 of 5

4 PLEASE HAVE THIS SECTION COMPLETED BY YOUR SUPERVISOR OR PERSONNEL MANAGER OF YOUR MOST RECENT EMPLOYER. IMPORTANT. THIS PAGE MUST BE MAILED WITH YOUR APPLICATION. DO NOT SEND SEPARATELY. YOUR APPLICATION CANNOT BE PROCESSED WITHOUT THIS COMPLETED SECTION. DO NOT USE THIS PAGE IF SELF-EMPLOYED. SELF-EMPLOYED APPLICANTS MUST PROVIDE TWO (2) NOTARIZED LETTERS OF REFERENCE FROM SEPARATE CLIENTS. 8. EMPLOYMENT VERIFICATION Employee s last name: First name: MI: Company Name: Dept/Div.: Mailing Address: City: ST/Prov.: Zip: Country: Supv/ Personnel Mgr Supv/Personnel Mgr Phone: ( ) PLEASE PRINT EXCEPT FOR SIGNATURE I verify that:, is / was employed by this company and conducted the duties (circle one) submitted in this application during the employment periods submitted in this application. My name is: My job title is: Date: Signature: 9. Photo Identification Card Applicants MUST submit one (1) passport-style color photograph. Please print your name and membership number (if applicable) on the reverse of the photograph. Your photo is a vital part of your application. To learn more, review the information on how to provide a suitable photo to avoid processing delays by visiting our website The acceptance of your photo is always at the discretion of the AWS. Photos copied or digitally scanned from driver s licenses or other official documents are not acceptable. DO NOT STAPLE OR PAPER CLIP PHOTO Photo Requirements: In color Printed on photo quality paper ONLY Photo is sharp (in focus) without any visible pixels or printer dots 2 x 2 inches (51 x 51 mm) in size Sized such that the head is between 1 inch and 1 3/8 inches (between 25 and 35 mm) from the bottom of the chin to the top of the head. Taken within the last 6 months to reflect your current appearance Taken in front of a plain white or off-white background Taken in full-face view directly facing the camera With a neutral facial expression and both eyes open 2 x2 Only use scotch tape on the back of the photo 2 x2 CRWT Beta Exam Rev. 9/11/2014 Page 4 of 5

5 10. TESTIMONIAL: (this section MUST be completed or application will be rejected) I hereby certify that I have read the standard requirements contained in AWS QC20. 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. Furthermore, I certify that I have not obtained any exam materials, have no prior knowledge of the AWS exam questions or answers, and have not and will not accept any solicitation for the AWS exam questions or answers from anyone at any time before or after the exam. I understand that a violation of this oath may be grounds for invalidation of my certification. Applicant s Signature Date CRWT Beta Exam Rev. 9/11/2014 Page 5 of 5