Mail to: 8669 Doral Blvd.

Suite 130 Doral, FL 33166-6640 (800) 443-9353 extension 273

Welding Inspector (CWI & SCWI) Renewal Application
Faxed or emailed applications are NOT accepted EXP. DATE

CERTIFICATION # AWS MEMBER # RENEWAL (CWI and SCWI ONLY)

METHOD OF PAYMENT
All checks and money orders should be made payable to AWS.

Payment must accompany your application.
Check or Money Order #_____________________ VISA MC AMEX Diners Discover

UPGRADE - applicants who met the minimum scores on each part of the examination
but did not meet the work experience requirements of CWI may request an upgrade to the CWI level once the work experience requirements are met.

Credit Card #

Last Name

Expiration Date

First Name

MI

Mo

Yr

Signature AWS USE ONLY

Mailing address

Date Acct #

City, State

Amt $

CWIR

Zip Code/Postal Code

Last 4 digits SS#

Date of Birth mm/dd/yyyy

Home Telephone Number

Work Telephone Number

Mobile Telephone Number

E-mail Address

Renewal/Upgrade Fees - Please visit our website http://www.aws.org/certification/pricelist/

Associations
Type of Business (check only ONE) A B C D E F G H I J K L M N O P Q R S Contract construction Chemicals & allied products Petroleum & coal industries Primary metal industries Fabricated metal products Machinery except elect. (incl. gas welding) Electrical equip., supplies, electrodes Transportation equip. - air, aerospace Transportation equip. - automotive Transportation equip. - boats, ships Transportation equip. - railroad Utilities Welding distributors & retail trade Misc. repair services (incl. welding shops) Educational Services (univ., libraries, schools) Engineering & architectural services (incl. assns.) Misc. business services (incl. commercial labs) Government (federal, state, local) Other 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 Job Classification (check only ONE) President, owner, partner, officer Manager, director, superintendent (orassistant) Sales Purchasing Engineer — welding Engineer — other Inspector, tester Supervisor, foreman Welder, welding or cutting operator Architect, designer Consultant Metallurgist Research & development Technician Educator Student Librarian Customer service Other Engineer - design Engineer - manufacturing 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

WI Renewal Application

Page 1 of 2

October 10, 2012

I give AWS permission to verify this information.2 of QC1. Standard for AWS Certification of Welding Inspectors.Detailed Description Required* Visual Acuity Record A current Visual Acuity Record must be completed and submitted with this application. please visit our website http://www. State. o AWS may send a renewal notice. the CWI must: o Submit an approved renewal application to the AWS Certification Department by the expiration date of the current certification and no earlier than 6 months prior to the expiration date of that certification.) To: (Mo. - - (Reproduce this section for each additional employer) Company Name Type of Business Company Phone Number Company Street Address Supervisor’s Name Supervisor’s Email Address Applicant’s Job Title City. 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.NAME AWS Member No. I understand that any false statements will nullify this application. Postal Code Title of Immediate Supervisor Department Employed From: (Mo. I further understand that any required information that is incomplete or missing will cancel this registration. Requirements (please refer to AWS QC1. but if not received.aws. I have read and agree to the terms and conditions set forth in the AWS Policies and Fees form. To be eligible for renewal. Testimonial (Applicants must read and sign the following statement in front of a notary) I hereby certify that I have read the standard requirements contained in AWS QC1. To download a copy of the form. 2012 . Applicant’s Signature Date AWS Policies and Fees .) Job Responsibilities.) (Yr.2.org/certification/docs/VisualAcuityRecord. I certify that the information I have included on this application is true. Further. Standard for AWS Certification of Welding Inspectors for further details) The period of validity for AWS SCWI and CWI certification is three (3) years. o SCWI/CWI not meeting the requirements of 15. SCWI/CWI certification renewals are limited to two consecutive three-year periods.4 from AWS QC1 may renew by taking the CWI part B Practical exam and meet the scoring requirements of 6.aws. I give AWS the right to reveal my certification status as it relates to my validity and expiration date only.) (Yr.org/certification/policiesfees/ The following is completed by a Notary Public Sworn to and subscribed before me this __________________________ day of__________________________ the year___________.1 and QC1 during the previous three years of certification.Please visit our website http://www. I agree to comply with the provisions set forth in the Standard concerning the administration of my examination and certification. Upon obtaining my certification. it remains the responsibility of the SCWI/CWI to renew on time. My commission expires ___________________ Notary Public Signature ___________________________________ (seal and/or stamp is REQUIRED) WI Renewal Application Page 2 of 2 October 10. I agree to comply with the existing requirements and any subsequent requirements instituted by AWS. The SCWI/CWI shall be responsible for maintaining a current address with the AWS Certification Department.pdf.

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