ASNT Level III Certification Application for QCCO

Transcription

1 ASNT Level III Certification Application for QCCO ASNT Identification Number If you have previously been given an ASNT identification number, please enter it in this box: Personal Data Mail certification information to: Home Work Mail membership material to: Home Work Mr Miss Mrs Ms Name Home Print your name as you would like it to appear on your certificate: First, Middle or Middle Initial, Last Address City State/Prov. ZIP/Postal Code Country Work Phone Fax * Organization Name Address City State/Prov. ZIP/Postal Code Country Phone Fax * Fees All fees are in US dollars. * Please check which is primary. This will be used for all correspondence. Save on certification fees by becoming an ASNT member. See page 7 for all the benefits members enjoy. Basic Examination Total From page 2 Method Examination Total From page 2 International Mailing Surcharge For all non-us Residents $40 Membership Option Payment Take advantage of member pricing now by completing the membership application on pages 7 and 8 and include the total here. Total Fees Less transfer in (if applicableinclude copy of transfer letter) - Total Due Payment must accompany application Check Wire Transfer Money Order If by check, make checks payable to Quality Control Company. Bank details for money transfer: Name of Bank: BNP Paribas Branch: Mohandessin Account Number: USD Swift Code:BNPAEGCXXXX *Credit Card Identification Number: Visa/MasterCard/Discover: The three-digit number is printed on the signature panel on the back of the card following the account number. American Express: The four-digit number is printed above the account number on the front of the card. App-liii-qcco-3b 1 of 8 Rev

2 Examination Scheduling Use the tables below to designate the examinations you would like to take. Please observe the application deadline date for the examination location and dates you are choosing. Note: This application is valid for initial certification and for recertification by examination. To renew without further examination (by points), you must use the ASNT Level III Renewal Application. All examinations are conducted in the English language. Location and Dates This application is valid only for ASNT examinations held by QCCO in Egypt. Location: Schedule To apply for an exam, enter the date and time when you d like to take the exam. Only one examination may be taken in a session. You may take a maximum of two (2) examinations per day at a scheduled test site. Check a box indicating if this is a new or added method, a retake of an exam that you failed within the last five years, or a recertification exam if you are currently certified in the method. Check a box indicating if this is a new or added method, a retake of an exam that you failed within the last five years, or a recertification exam if you are currently certified in the method. Basic Examinations First time applicants must take a Basic examination. To become certified as an ASNT NDT Level III in any method, the NDT Basic examination and the method examination must be passed. To become certified as an ASNT PdM Level III, both the PdM Basic examination and the IR method examination must be passed. Exam NDT Basic PdM* Basic Date *PdM Level III certification is available only in IR. NDT Level III certification is available in all 10 methods. Method Examinations Time (0800 or 1400) ASNT Members New Retake $610 $535 Non-Members** New Retake $685 $610 Basic Examination Total Fee Exam AE Date Time (0800 or 1400) ASNT Members New/Recert Retake $610 $535 Non-Members** New/Recert Retake $685 $610 Fee ET IR* LT MT NR PT RT UT VT *For IR, NDT Level III and PdM Level III certification is available. Only NDT Level III certification is available in the other methods. Method Examination Total **You may take advantage of ASNT Member pricing now by becoming an ASNT member or renewing your membership with this application. App-liii-qcco-3b 2 of 8 Rev

3 Education & Experience Requirements ASNT Level III applicants must satisfy one of the following eligibility criteria: Graduated from a minimum four-year college or university curriculum with a degree in engineering or a physical science, plus one year (12 months) of experience in nondestructive testing in an assignment comparable to that of an Level II in the applicable test method(s), as defined in ASNT s Recommended Practice No. SNT-TC-1A, latest edition; OR Completed with passing grades at least two full academic school years of engineering or a physical science study at a university, college, or technical school, plus two years (24 months) of experience in nondestructive testing in an assignment comparable to that of an Level II in the applicable test method(s), as defined in ASNT s Recommended Practice No. SNT-TC-1A, latest edition; OR Four years (48 months) of experience in an assignment at least comparable to that of an Level II in the applicable test method(s), as defined in ASNT s Recommended Practice No. SNT-TC-1A, latest edition. If you do not satisfy the above criteria for the method(s) in which you are applying, please do not submit an application. Applications received from ineligible applicants will be returned to the applicant in accordance with the Transfer / Cancellation / Refund Policy. It is your responsibility to determine your own eligibility. Each time a new examination is attempted, you must supply documentary evidence of education and experience appropriate for that examination. Do not rely on past applications to meet this requirement. Recertifying and retaking personnel need only submit information new since the last application. Education You must attach documentation for education if you are using post-secondary education to meet the Education and Experience Requirements. Copies of diplomas or transcripts are acceptable. All documentation must be in English or accompanied by an English translation. Highest Level of Educational Achievement List the name and address of the institution where your highest level of education was obtained as it relates to your ASNT Certification. High School Diploma 2 or more years of College in Engineering or Science 2-year Technical/College Degree 4-year College Degree Institution Address Major Course of Study Degree App-liii-qcco-3b 3 of 8 Rev

4 Experience Photocopy this page as necessary to list your experience history. List positions in reverse chronological order. You must supply documentary evidence of Level II or equivalent experience to meet the minimum experience requirements in the method(s) for which you are applying appropriate to your highest level of education as described in the Education & Experience Requirements section on page 3. Acceptable documents include employer or third-party certificates or certification records, human resources records, a signed statement from the employer or responsible Level III, a signed statement from an ASNT Level III or ACCP Professional Level III, or, for self-employed personnel, signed statements from at least two (2) customers. All documentation must be in English or accompanied by an English translation. Position # Dates of Employment Start Date End Date Total Time (Months) Organization Name Employer Contact Name Organization Address City State/Prov. ZIP/Postal Code Country Phone Fax Check methods below where NDT/PdM job functions were performed and indicate comparable Level. AE ET IR LT MT NR PT RT UT VT Level Level Level Level Level Level Level Level Level Level Attachments: List the document(s) that are attached to this application as evidence of this engagement. Position # Dates of Employment Start Date End Date Total Time (Months) Organization Name Employer Contact Name Organization Address City State/Prov. ZIP/Postal Code Country Phone Fax Check methods below where NDT/PdM job functions were performed and indicate comparable Level. AE ET IR LT MT NR PT RT UT VT Level Level Level Level Level Level Level Level Level Level Attachments: List the document(s) that are attached to this application as evidence of this engagement. App-liii-qcco-3b 4 of 8 Rev

5 Transfer / Cancellation / Refund Policy All ASNT examinations are required to be taken within one calendar year from the date on the original Letter of Notification or Letter of Approval sent to the applicant. One transfer is permitted within that year, subject to the administrative fees detailed below. Failure to take examinations within that oneyear period will result in forfeiture of all fees to ASNT. The transfer or cancellation deadline is two (2) calendar weeks prior to the week of a scheduled examination. Transfers or cancellations received before the deadline will be subject to a $75.00 administrative fee PER EXAMINATION. A transferring applicant must remit those administrative fees to ASNT by the application deadline for the rescheduled examination. No examination attendance will be permitted unless all fees are paid. Canceling applicants will receive a refund less all administrative fees. No transfers or cancellations will be accepted after the above transfer deadline. Failure to show up ( No Shows ) for scheduled examinations will result in forfeiture of the fees for the missed examinations. If an examination application is received and the applicant is found to be unqualified to take the examination, a refund will be issued less an administrative fee of $75.00 PER EXAMINATION. All requests for transfers or cancellations must be submitted in writing to ASNT and be signed by the person registered for the examination. A signed fax transmittal is acceptable. The International Surcharge and Membership / Administrative Fees are non-refundable and non-transferable. No exceptions will be made to the above policy. Statements and Signature By signature on this application, if certified by ASNT, I agree to abide by the Code of Ethics for Level III Personnel Certified by ASNT so long as I maintain a Certificate. Further, I understand the right of ASNT to suspend or revoke any Certificate granted if I abuse the privileges therein granted to me. I understand that certifications which may result from this application do not constitute any form of license. I hereby attest that all facts on this application are true and correct and no information which might be detrimental has been withheld. ASNT may make any inquiries necessary to determine my qualifications for certification. I agree to abide by the decision of ASNT relative to the granting of any Certifications as applied for herein. For valuable consideration, the undersigned, having made application for Certification as Level III before ASNT, does hereby release and forever discharge The American Society For Nondestructive Testing, an Ohio Corporation, from any and all liabilities, claims, demands, or causes of action whatsoever, which now exist or which may hereafter arise on account of the undersigned s activities henceforth as Level III certified by ASNT. The undersigned further acknowledges that this release is being given as a prerequisite for having filed application for consideration by ASNT. The undersigned further represents that if not certified by ASNT, then this release and discharge shall have no force and effect; otherwise, upon certification as set forth above, this release shall be binding on the undersigned and The American Society for Nondestructive Testing, Inc. and any and all agents of ASNT in connection with such certification process. I have read and understand the transfer, cancellation and refund policy. I have read and understand the attached transfer, cancellation and refund policy and understand that all application documents submitted to ASNT become the property of ASNT. I authorize ASNT to publish my name, city, state, country, test methods, Levels and expiration dates of certification. Signature of Applicant Print Name of Applicant Date Submit Application Mail this application, accompanying documents, and payment to QCCO: Quality Control Co. QCCO 3 Nablous St. Mohandsein, Cairo Egypt Contact: Mohsen Hassanein Phone: Fax: mohsen.hassanein@qualitycontrol-egypt.com App-liii-qcco-3b 5 of 8 Rev

6 Code of Ethics for Level III Personnel Certified by ASNT 1. Preamble In order to safeguard the life, health, property, and welfare of the public, to maintain integrity and high standards of skills and practices in the profession of nondestructive testing, the following rules of professional conduct shall be binding upon every person issued a certificate by ASNT as a Level III The Level III who holds a certificate is charged with having knowledge of the existence of the reasonable rules and regulations hereinafter provided for his/her conduct as ASNT Level III, and also shall be familiar with their provisions and understand them. Such knowledge shall encompass the understanding that the practice of nondestructive testing under this certification is a privilege, as opposed to a right, and the Level III shall be forthright and candid in statements or written responses to the Ethics Committee of the Certification Management Board The Level III as referred to herein is that individual who has been issued a certificate by the American Society for Nondestructive Testing, Inc. pursuant to its heretofore published requirements, rules, and procedures for such certification. This Code of Ethics is binding upon all individuals so certified. 2. Integrity The Level III is obligated to act with complete integrity in professional matters for each client or employer as a faithful agent or trustee; shall be honest and impartial; and shall serve the public, clients, and employer with devotion. 3. Responsibility to the Public The Level III shall protect the safety, health, and welfare of the public in the performance of professional duties. Should the case arise where the Level III faces a situation where the safety, health, and welfare of the public are not protected, he/she shall: 3.1. Apprise the proper authority if it is evident that the safety, health, and welfare of the public are not being protected; and 3.2. Refuse to accept responsibility for the design, report, or statement involved; and 3.3. If necessary, sever relationship with the employer or client; and 3.4. Undertake to perform assignments only when qualified by training and experience in the specific technical fields involved. In the event a question arises as to the competence of an Level III to perform an assignment in a field of specific discipline which cannot be otherwise resolved to the Ethics Committee s satisfaction, the Ethics Committee, either upon request of the Level III, or by its own volition, may require him/her to submit to an appropriate inquiry by or on behalf of the Ethics Committee; and 3.5. Be completely objective in any professional report, statement, or testimony, avoiding any omission which would, or reasonably could, lead to fallacious inference, finding, or misrepresentation; and 3.6. Express an opinion as a technical witness before any court, commission, or other tribunal, only when such opinion is founded upon adequate knowledge of the facts in issue, upon a background of technical competence in the subject matter, and upon an honest conviction of the accuracy or propriety of the testimony. 4. Public Statements 4.1. The Level III will issue no statements, criticisms, or arguments on nondestructive testing matters connected with public policy which are inspired or paid for by an interested party, or parties, unless he/she has prefaced the remark(s) by explicitly identifying himself/herself, by disclosing the identities of the party, on whose behalf he/she is speaking, and by revealing the existence of any pecuniary interest he/she may have in these matters The Level III will publicly express no opinion on a nondestructive testing matter unless it is founded upon adequate knowledge of the facts in issue, upon a background of technical competence in the subject matter, and upon honest conviction of the accuracy and propriety of the testimony. 5. Conflict of Interest 5.1. The Level III shall conscientiously avoid conflict of interest with the employer or client, but when unavoidable, shall forthwith disclose the circumstances to the employer or client The Level III shall promptly inform the client or employer of any business associations, interests, or circumstances which could influence his/her judgment or the quality of services to the client or employer The Level III shall not accept compensation, financial or otherwise, from more than one party for services on the same project, or for services pertaining to the same project, unless the circumstances are fully disclosed to, and agreed to, by all interested parties or their duly authorized agents The Level III shall not solicit or accept financial or other valuable consideration from material or equipment suppliers for specifying their products The Level III shall not solicit or accept gratuities, directly or indirectly, from contractors, their agents, or other parties dealing with the client or employer in connection with work for which he/she is responsible As an elected, retained, or employed public official, the Level III (in the capacity as a public official) shall not review or approve work that was performed by himself/herself, or under his/her direction, on behalf of another employer or client. 6. Solicitation of Employment 6.1. The Level III shall not pay, solicit, nor offer, directly or indirectly, any bribe or commission for professional employment with the exception of payment of the usual commission for securing salaried positions through licensed employment agencies The Level III shall seek professional employment on the basis of qualification and competence for proper accomplishment of work The Level III shall not falsify or permit misrepresentation of his/her, or his/her associates, academic or professional qualification. He/she shall not misrepresent or exaggerate the degree of responsibility in or for the subject matter of prior assignments Brochures or other presentations incident to the solicitation of employment shall not misrepresent pertinent facts concerning employers, employees, associates, joint ventures, or past accomplishments with the intent and purpose of enhancing qualifications and work. 7. Improper Conduct 7.1. The Level III shall not sign documents for work for which he/she does not have personal professional knowledge and direct technical supervisory control and responsibility The Level III shall not knowingly associate with, or permit the use of, his/her name or firm name in a business venture by any person or firm which he/she knows, or has reason to believe is engaging in business or professional practices of a fraudulent or dishonest nature. 8. Unauthorized Practice Any violation of this code shall be deemed to be an unauthorized practice and upon proper complaint, investigation, due process hearing and ruling of the Ethics Committee of the ASNT Certification Management Council in accordance with procedures heretofore established and published, sanctions may be applied to the individual(s) in violation. 9. Rulings of Other Jurisdictions Conviction of a felony while ASNT certification is valid or the revocation or suspension of a Professional Engineer s License by another jurisdiction or similar rulings by other professional associations may be grounds for a charge of violation of this Code. App-liii-qcco-3b 6 of 8 Rev

7 ASNT Individual Membership Application & Renewal Form Member Information Last Name First Name M.I. Phone Send Membership Materials to: О Home О Office Former Member: О Yes О 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 joining for five years to receive maximum savings. There is no better network for you to be connected when it comes to your NDT career. Stay informed throughout your certification period by maintaining membership along with your certification. ASNT membership keeps you informed of the latest in technology in addition to savings on certification exams. ASNT membership includes: 25% discount on all items purchased from our Publications Catalog or Shop ASNT online at Membership Options Renewal Member Dues To 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 business networking opportunities The quarterly newsletter for NDT practitioners: The NDT Technician Recertification points for membership Discounts on national conferences and symposium registration Members Only access at provides publications and networking functions Serve on ASNT committees; be part of a group that may effect change or the industry Become part of the foremost nondestructive testing society and be fully connected to the NDT world. New Member Dues New members are those joining ASNT for the first time or members having more than a six month gap since expiration. Such rejoining members, are subject to new member rate. Renewal Member Dues *Dues with Airmail Service included *New Member Dues *Dues with Airmail Service included One-Year О $65 О $113 О $75 О $123 Two-Year О $125 О $209 О $135 О $219 Three-Year О $180 О $294 О $190 О $304 Five-Year О $290 О $465 О $300 О $475 Student, One-Year Must submit transcript or letter or enrollment О $15 О $63 О $15 О $63 Military Rank E-5 or lower О $30 О $78 О $30 О $78 Dues include subscriptions to Materials Evaluation and The NDT Technician. For members outside North America: Unless airmail is specified, all materials will be sent sea/surface mail; allow 3-4 months for delivery. *Airmail service is restricted by availability or cost; airmail may not be offered to your country. You will be contacted if service cannot be provided. All 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 RNDE is ASNT s quarterly research journal. With Airmail Service Included Print Subscription - for current volume О $55 О $129 Electronic Subscription - for current volume О $55 Print and Electronic Subscription - a savings of $35 О $75 О $149 All pricing subject to change. Add a subscription to ASNT s quarterly research journal, RNDE. 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. App-liii-qcco-3b 7 of 8 Rev

8 Membership Profile 1. Year of Birth 9. Choose the one business segment that best describes your company. (select only one) 2. Gender О Male О Female NDT Utilization Business 3. Highest Education Level О Aerospace/Aviation/Aircraft О Medical О Grades 1-12 О Amusement Rides & Skiing О Nuclear О High School Diploma О Automotive О Optical О Some College О Chemical & Petroleum О Ordnance О 2-Year Associate Degree О Construction О Pipeline О 4-Year Undergraduate Degree О Commercial Labs О Pulp/Paper О Master's Degree О Infrastructure (Roads & Bridges) О Railroad О Doctorate Degree О Electronics О Semiconductor О Marine О Utilities 4. Years of Experience in NDT NDT Supplier Business О1-5 О6-10 О11-15 О16-20 О21 & over О Consulting О Robotics О Distributor/Manufacturer's О Supplies 5. Number of people involved with NDT at О Representative О Training your company О Equipment О Computer Software О1-5 О6-20 О21-50 О О over 100 О Research О Computer Hardware 6. Your Job Function - Choose the one that best describes your role. (select only one) 10. Choose the primary type of NDT that you do. (select only one) О NDT Management О Sales/Marketing О Design and Failure Analysis О Quality Management О Researcher О Field Inspection О Engineer О Academic/Educator О Incoming Inspection О Technician/Inspector О Trainer/Instructor О In-service, Plant/Operation Maintenance & Process Control О Consultant О Student О Product Life Extension О QA/QC Reliability О None of the above 7. Purchasing Responsibility (select all that apply) I recommend/approve the purchase of: 11. Highest Level of NDT qualification (select only one) О Equipment/Instruments/Supplies О None О ASNT NDT Level III О Training & Study Materials/Programs О Level I О ACCP Level II О Services О Level II О ACCP Level III О I am not involved in purchasing О Level III О IRRSP 8. With which NDT method(s) do you work? (select all that apply) О Acoustic Emission О Alternating Current Field Measurement О Electromagnetic/Eddy Current О Ground Penetrating Radar О Infrared & Thermal О Laser О Leak О Liquid Penetrant О Magnetic Flux Leakage О Magnetic Particle О Neutron Radiography О Radiography О Ultrasonics О Vibration Analysis О Visual For Questions Contact the Membership Department at: Phone Toll Free (US/Canada) App-liii-qcco-3b 8 of 8 Rev