Welding Inspector Exam Application AWS V4 CWI Only Pkg
User Manual: AWS V4
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Welding Inspector Exam application Page 1 of 5 April 2, 2014
Last Name First Name MI
I am applying for: CAWI Only CWI Only
1. Indicate the exam location of your choice:
PLEASE ALLOW 3-4 WEEKS TO RECEIVE A CONFIRMATION LETTER TO THE EMAIL ADDRESS IN SECTION 6. OTHERWISE, IT WILL BE MAIILED.
1st Site Code: ________________ Exam Date: _________________ City/State: ___________________________ *Submission Deadline: __________________
2nd Site Code: ________________ Exam Date: _________________ City/State: ___________________________ *Submission Deadline: __________________
3rd Site Code: ________________ Exam Date: _________________ City/State: ___________________________ *Submission Deadline: __________________
NOTE: AWS strongly recommends the applicant indicate an alternate second and third site location. If the first choice is not available, registration will indicate
the next available choice site. Please do not make any hotel or flight arrangements until you have received your exam confirmation letter from the Certification
Department via email. * Please refer to AWS Policies and Fees.
CERTIFIED WELDING INSPECTOR
EXAM APPLICATION
4. Indicate the following AWS seminar of your choice or
choose “Examination Only” below
D1.1 SEMINAR WEEK PAK (code book included)
1. D1.1 Code Clinic(Sun 1 PM – 5 PM & Mon 8 AM - 12 Noon)
2. Welding Inspection Technology Workshop
(Tues – Thurs 8 AM – 5 PM)
3. Visual Inspection Workshop (Fri 8 AM – 5 PM)
4. Certification Exam (Sat 8 AM – 5 PM)
add CWI Pre-Seminar (online course only)
API 1104 SEMINAR WEEK PAK (code book not provided)
1. API 1104 Code Clinic (Mon 1 PM – 5 PM)
2. Welding Inspection Technology Workshop (Tues – Thurs 8 AM – 5 PM)
3. Visual Inspection Workshop (Fri 8 AM – 5 PM)
4. Certification Exam (Sat 8 AM – 5 PM)
add CWI Pre-Seminar (online course only)
FOR INDIVIDUAL CODE CLINICS/WORKSHOPS:
D1.1 Code Clinic (code book not supplied)
API-1104 Code Clinic (code book not supplied)
Welding Inspection Technology Workshop
Visual Inspection Workshop
CWI Pre-Seminar (online course only)
EXAMINATION ONLY (MUST PROVIDE OWN CODE BOOK)
2. Check and complete the following
Your AWS Member # (if applicable):__________________________
Check here if taking a non-AWS seminar prior to the exam.
Name of Agency
City, State: Date:
3. Select one of the following code application test subject
AWS D1.1 – Structural Steel Code
API-1104 – Pipelines
AWS D1.2 – Structural Aluminum Code *Code Clinic not available.
AWS D1.5 – Bridge Welding Code *Code Clinic not available.
AWS D15.1 – Railroad *Code Clinic not available.
AWS D17.1 – Aerospace *Code Clinic not available.
ASME Sections VIII (Div 1) & IX *Code Clinic not available.
ASME Section IX, B31.1 and B31.3 *Code Clinic not available.
5. METHOD OF PAYMENT- ALL CHECKS AND MONEY ORDERS SHOULD BE MADE PAYABLE TO AWS.
AWS USE ONLY
PAYMENT MUST ACCOMPANY YOUR APPLICATION
Acct #:
Check or money order #_______________________
VISA MC AMEX Diners Discover
Date:
CC#: /// Exp: /
SIGNATURE
Amt $: CWI
8669 NW 36 St, # 130 Miami, FL 33166-6672
(800) 443-9353 or (305) 443-9353, ext. 273
For code book editions and other exam information please visit our website
www.aws.org/certification/endorsebok
Exam Fees- Please visit our website http://www.aws.org/certification/pricelist/
Faxed or emailed applications are NOT accepted
For code book editions and other exam information visit our website
www.aws.org/certification/endorsebok
Seminar/Exam Schedule- Please visit our website http://www.aws.org/w/a/registrations/prices_schedules.html
NAME: AWS MEMBER # __________________________________
Welding Inspector Exam application Page 2 of 5 April 2, 2014
6. Personal Information
Address
Address (cont’d) Apt #
City and State / Province / Country Zip Code
Home Telephone Number Work Telephone Number Mobile Telephone Number
Sign me up to receive text alerts regarding my certification status.
Sign me up to receive text information regarding other AWS products and special promotions.
*Normal text messaging rates & fees apply as determined by your cellular provider.
DATE OF BIRTH MM/DD/YY U.S. SOCIAL SECURITY NUMBER
x
x
x
x
x
E-Mail Address (Confirmation notification will be sent to this address)
7. Associations
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
Technical Interests
(check ALL that apply)
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
NAME: AWS MEMBER # __________________________________
Welding Inspector Exam application Page 3 of 5 April 2, 2014
8. Education Level
Check the appropriate box below
9. Additional Education and Experience
VoTech credits - MUST attach
transcripts of welding related
courses or diploma
Circle no. of years attended
0 1 2 3 4
Maximum one (1) year work substitution credit only if courses
completed and within a curriculum related to welding.
College credits - MUST attach
transcripts of engineering-level
courses or diploma
Circle no. of years attended
0 1 2 3 4
Maximum two (2) years work substitution credit only if the degree
is in engineering technology, engineering, or physical science
10. 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 CWI/CAWI ELIGIBILITY.
_______ I understand that all work experience documented on this application will be verified by AWS prior to exam confirmation.
(Initials)
High school graduate or achieved GED certificate.
CWI applicants must document five (5) years and CAWI applicants must document two (2) years of work experience in the Qualifying
Work Experience Section below. (Please refer to the AWS B5.1)
Did not graduate high school, but completed the 8th grade.
CWI applicants must document nine (9) years and CAWI applicants must document four (4) years of work experience in the Qualifying
Work Experience Section below. (Please refer to the AWS B5.1)
Did not complete the 8th grade.
CWI applicants must document twelve (12) years and CAWI applicants must document six (6) years of work experience in the Qualifying
Work Experience Section below. (Please refer to the AWS B5.1)
Company Name
Type of Business
Company Phone Number
Company Street Address City, State, Zip 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
Company Name
Type of Business
Company Phone Number
Company Street Address City, State, Zip 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
NAME: AWS MEMBER # __________________________________
Welding Inspector Exam application Page 4 of 5 April 2, 2014
11. Employment Verification
This section MUST be completed by a supervisor or personnel manager for the most recent employer indicated in section 10. 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. If the employer is no longer in business, please include a copy of the W2 form.
Company Name: _________________________________________ Company Phone: __________________________________________
Company Address: ___________________________________________________________________________________________________
City, State: __________________________________________________ Zip Code: _________________________ Country: _____________
I ______________________________________________ , verify that __________________________________ maintained employment at
________________________________________ from _________________________ to __________________________ .
Signature: _________________________________________________________________ Date: __________________________________
12. Visual Acuity Record
A current Visual Acuity Record must be completed and submitted with this application. To download a copy of the form, please
visit our website http://www.aws.org/certification/docs/VisualAcuityRecord.pdf.
IMPORTANT: This form must be completed and received in the AWS Certification Department not later than 30 days after the
applicant’s completed examination date. Applicants who have not fulfilled all requirements within 30 days after the
examination date shall have all records, scores and applications voided and may be in jeopardy of forfeiting application fees.
13. 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
http://www.aws.org/w/a/certification/photoidreqs.html . The acceptance of your photo is always at the discretion of the AWS.
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
Supervisor/Personnel Manager’s Name
(print)
Employee’s Name (print)
Company Name
Supervisor/Personnel Manager’s Name
(print)
Date mm/yyyy
Date mm/yyyy or Present
Month/Day/Year
2”x2”
2”x2”
Photos copied or digitally scanned from
driver’s licenses or other official
documents are not acceptable.
Only use scotch tape on
the back of the photo
NAME: AWS MEMBER # __________________________________
Welding Inspector Exam application Page 5 of 5 April 2, 2014
14. ADA Accomodations
By checking this box I am requesting special accommodations due to a disability. I agree that I have read AWS Disability
Accommodations requirements and agree to the terms and conditions set forth. A copy of the ADA form can be found at
http://www.aws.org/certification/docs/ADA_accom.pdf .
15. Testimonial
(Applicants must read and sign the following statement in front of a notary)
Certified Welding Inspector
QC1 Standard for the AWS Certification of Welding Inspectors & B5.1 Specification for the Qualification of Welding Inspectors
I hereby certify that I have read the standard requirements contained in the certification programs indicated above. Further, I
agree to comply with the existing requirements and any subsequent requirements that may be 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.
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 _________________________
THE FOLLOWING IS TO BE COMPLETED BY A NOTARY PUBLIC
Sworn to and subscribed before me this _______ day of______________________ 20____.
My commission expires ___________________ Notary Public Signature ________________________________
NOTARY STAMP AND/OR SEAL IS REQUIRED
