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Certification Application
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Rev 6/27/14

Exam Date Time (8 AM or 2 PM) ASNT Members Non-Members** New $260 New $335 Retake $185 Retake $260 Fee NDT Basic Method Examinations Exam Date Time (8 AM or 2 PM) ASNT Members New/Recert $260 Retake $185 Non-Members** New/Recert $335 Retake $260 Fee ET IR LT ML MT NR PT RT UT VT Method Examination Total: **You may take advantage of ASNT Member pricing now by becoming an ASNT member or renewing your membership with this application. the NDT Basic examination and at least one Method examination must be passed. just enter “AEC”. just write “AEC” under “Date”. You may take a maximum of two (2) examinations per day at a scheduled test site. If all certifications lapse. First time applicants must take the Basic and at least one Method examination. You will schedule the date and time of your examination directly with the AEC after you receive your Notification of Approval from ASNT. Once certification is achieved. additional methods may be added without retaking the Basic examination. You may also choose to take your examination(s) at one of ASNT’S Authorized Examination Centers (AECs). Exam dates are listed in the ASNT Examination Schedule. app-liii-3 2 of 8 Rev 6/27/14 . To renew without further examination (by points). Note: This application is valid for initial certification and for recertification by examination. Only one examination may be taken in a session. Check a box indicating if this is a new or added method. If you are applying to take your examination at an AEC. a retake of an exam that you failed within the last five years. Please observe the application deadline date for the examination location and dates you are choosing. enter the date and time when you’d like to take the exam.Examination Scheduling Use the tables below to designate the examinations you would like to take. you must use the ASNT Level III Renewal Application. Schedule To apply for an exam. Basic Examinations To become certified as an ASNT NDT Level III. Location and Dates Location: Select a location from the ASNT US Examination Schedule and enter the location of the exam here. the Basic examination and the Method examination(s) must be retaken to regain certification. If you are applying to take your examination at an AEC. Authorized Examination Centers may charge additional fees. or a recertification exam if you are currently certified in the method.

OR Completed with passing grades at least two full academic school years of engineering or a physical science study at a university. SNT-TC-1A. please do not submit an application. Institution 2 or more years of College in Engineering or Science Address 2-year Technical/College Degree 4-year College Degree Major Course of Study Degree app-liii-3 3 of 8 Rev 6/27/14 . latest edition. latest edition. Copies of diplomas or transcripts are acceptable. 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. SNT-TC-1A. Education You must attach documentation for education if you are using post-secondary education to meet the Education and Experience Requirements. Recertifying and retaking personnel need only submit information new since the last application. Applications received from ineligible applicants will be returned to the applicant in accordance with the Transfer / Cancellation / Refund Policy. Level of Post-Secondary Education List the name and address of the institution where your highest level of education was obtained as it relates to your ASNT Certification. If you do not satisfy the above criteria for the method(s) in which you are applying. All documentation must be in English or accompanied by an English translation. as defined in ASNT’s Recommended Practice No. as defined in ASNT’s Recommended Practice No.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. Do not rely on past applications to meet this requirement. 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). college. latest edition. Each time a new examination is attempted. you must supply documentary evidence of education and experience appropriate for that examination. or technical school. It is your responsibility to determine your own eligibility. 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).

Acceptable (other) documentation can include. List the document(s) that are attached to this application as evidence of this engagement. If Statement Option below is not completed by employer/customer. Number of months working Level II or comparable of that of a Level II Other supporting documents that are NOT accepted: 1. a signed statement from an ASNT Level III or ACCP Professional Level III. signed statements from at least two (2) customers. for self-employed personnel. All documentation must be in English or accompanied by an English translation. Level of qualification or Level II job duties 2. ZIP/Postal Code Phone Fax Email Country Check experience (months performing work with Level II qualifications) by method as related to above employer. Middle. Employer/Agent/Customer Signature Date Employer/Agent/Customer Name (print) Employer Contact Number or Email Address Title / Position ASNT ID # (if applicable) app-liii-3 4 of 8 Rev 6/27/14 . ET __ # of months IR __ # of months NR __ # of months PT __ # of months LT __ # of months MT __ # of months ML __ # of months RT __ # of months UT __ # of months VT __ # of months Briefly describe below the NDT tasks the candidate named above performed at this location for each of the methods checked. for self-employed personnel. Last ASNT ID Position # Dates of Employment Start Date End Date Total Time (Months) Organization Name Employer/Customer Contact Name Organization Address City State/Prov. I confirm that the information given above is true and correct. Statement Option .As the above named candidate’s employer or a designated and responsible agent of the above named candidate’s employer or as a customer of the candidate. or. or. Level I certificates Name__________________________________________________________________________ First. you will need to submit other documentation supporting your work experience. List positions in order by most recent (including present employer). 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. Other supporting documents MUST state: 1.Experience Photocopy this page as necessary to list your experience history. The Statement Option form at the bottom of this page is acceptable as documentary evidence of work experience. a signed statement from the employer or responsible Level III. employer or third-party certificates or certification records. signed statements from at least two (2) customers. III or ACCP Professional Level III. Certificate of Training / Non-employer issued qualifications 2. human resources records.

00 administrative fee PER EXAMINATION. Failure to take examinations within that one-year period will result in forfeiture of all fees to ASNT. cancellation and refund policy and understand that all application documents submitted to ASNT become the property of ASNT. I agree not to release confidential examination materials or participate in fraudulent test-taking practices. an Ohio Corporation. and any and all agents of ASNT in connection with such certification process. claims. app-liii-3 5 of 8 Rev 6/27/14 . Box 28518 Columbus. Signature of Applicant Print Name of Applicant Date Submit Application Mail Fax Mail this application. demands. One transfer is permitted within that year. expiration dates of certification(s) and any possible suspension or revocation of certification(s) by ASNT. city. Make checks payable to ASNT. from any and all liabilities. the undersigned. All requests for transfers or cancellations must be submitted in writing to ASNT and be signed by the person registered for the examination. I authorize ASNT to publish my name.00 PER EXAMINATION. which now exist or which may hereafter arise on account of the undersigned’s activities henceforth as Level III certified by ASNT. OH 43228-0518 US 614-274-6899 Please do not both mail and fax your application. upon certification as set forth above. A transferring applicant must remit those administrative fees to ASNT by the application deadline for the rescheduled examination. you may fax this application. if paying by credit card. or causes of action whatsoever. test methods. I agree to abide by the Code of Ethics for Level III Personnel Certified by ASNT so long as I maintain a Certificate. No examination attendance will be permitted unless all fees are paid. Inc. If an examination application is received and the applicant is found to be unqualified to take the examination. I understand that I am required to inform ASNT of matters that affect my capability to continue to fulfill the requirements of my certification(s). The transfer or cancellation deadline is two (2) calendar weeks prior to the week of a scheduled examination. No exceptions will be made to the above policy. Canceling applicants will receive a refund less all administrative fees. state. I hereby attest that all facts on this application are true and correct and no information which might be detrimental has been withheld. I understand that certifications which may result from this application do not constitute any form of license. For valuable consideration. this release shall be binding on the undersigned and The American Society for Nondestructive Testing. No transfers or cancellations will be accepted after the above transfer deadline. Further. The International Surcharge and Membership / Administrative Fees are non-refundable and non-transferable. levels. a refund will be issued less an administrative fee of $75. having made application for Certification as Level III before ASNT. Failure to do so may result in the suspension or revocation of my certification(s) by ASNT. Statements and Signature By signature on this application. Failure to show up (“No Shows”) for scheduled examinations will result in forfeiture of the fees for the missed examinations. I have read and understand the transfer. if certified by ASNT. ASNT may make any inquiries necessary to determine my qualifications for certification. The undersigned further acknowledges that this release is being given as a prerequisite for having filed application for consideration by ASNT. attachments. then this release and discharge shall have no force and effect. attachments. otherwise. subject to the administrative fees detailed below. A signed fax transmittal is acceptable. does hereby release and forever discharge The American Society For Nondestructive Testing. I understand the right of ASNT to suspend or revoke any Certificate granted if I abuse the privileges therein granted to me. and fees to ASNT at: ASNT 1711 Arlingate Lane P. Transfers or cancellations received before the deadline will be subject to a $75.O. The undersigned further represents that if not certified by ASNT.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. and fees to ASNT at: Or. I agree to abide by the decision of ASNT relative to the granting of any Certifications as applied for herein. country.

Brochures or other presentations incident to the solicitation of employment shall not misrepresent pertinent facts concerning employers. commission.1. to maintain integrity and high standards of skills and practices in the profession of nondestructive testing. any bribe or commission for professional employment with the exception of payment of the usual commission for securing salaried positions through licensed employment agencies. Refuse to accept responsibility for the design. criticisms. The Level III will issue no statements. on behalf of another employer or client. and also shall be familiar with their provisions and understand them. Should the case arise where the Level III faces a situation where the safety. Public Statements 4. 6.1. and welfare of the public are not being protected.5. employees. sever relationship with the employer or client. 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. either upon request of the Level III. and by revealing the existence of any pecuniary interest he/she may have in these matters. The Level III shall not knowingly associate with. 6. and upon honest conviction of the accuracy and propriety of the testimony.5. 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 shall not accept compensation. but when avoidable. by disclosing the identities of the party. and 3. clients. If necessary. This Code of Ethics is binding upon all individuals so certified. or under his/her direction. 5.3. or statement involved.1. 7. academic or professional qualification. may require him/her to submit to an appropriate inquiry by or on behalf of the Ethics Committee.1. finding. upon a background of technical competence in the subject matter. 1. The Level III shall promptly inform the client or employer of any business associations. their agents. and welfare of the public are not protected. shall forthwith disclose the circumstances to the employer or client. Responsibility to the Public The Level III shall: 3. app-liii-3 6 of 8 Rev 6/27/14 . and 3. 5.2. and employer with devotion. report. health. 2.2. or circumstances which could influence his/her judgment or the quality of services to the client or employer. and 3. or for services pertaining to the same project. If the applied sanction is suspension or revocation of certification. 9. Unauthorized Practice 8. Be completely objective in any professional report. on whose behalf he/she is speaking. Improper Conduct 7. Preamble 5. Protect the safety.1. 5. The Level III shall seek professional employment on the basis of qualification and competence for proper accomplishment of work. and upon an honest conviction of the accuracy or propriety of the testimony. or parties. only when such opinion is founded upon adequate knowledge of the facts in issue. 6.2. The Level III shall not solicit or accept gratuities. 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. Conflict of Interest 5. He/she shall not misrepresent or exaggerate the degree of responsibility in or for the subject matter of prior assignments. or other parties dealing with the client or employer in connection with work for which he/she is responsible.2. the Level III (in the capacity as a public official) shall not review or approve work that was performed by himself/herself.2. associates. In order to safeguard the life. avoiding any omission which would. directly or indirectly.3. The Level III shall make claims regarding certification only with respect to the scope for which certification has been granted. Express an opinion as a technical witness before any court. or past accomplishments with the intent and purpose of enhancing qualifications and work. from more than one party for services on the same project.4. and shall serve the public. from contractors. pursuant to its heretofore published requirements.2. property. or by its own volition. joint ventures. and 3. 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.1. The Level III shall not falsify or permit misrepresentation of his/her. 1.Code of Ethics for Level III Personnel Certified by ASNT 1.4. 1. rules.1. directly or indirectly. 7. nor offer. As an elected.1. 3. The Level III is obligated to act with complete integrity in professional matters for each client or employer as a faithful agent or trustee. and procedures for such certification.6. as opposed to a right. or testimony.1. 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. due process hearing and ruling of the Ethics Committee of the ASNT Certification Management Council in accordance with procedures heretofore established and published. or misrepresentation.1.4. nor to make any statement regarding the certification which ASNT may consider misleading or unauthorized.1.1. the certificate holder agrees to discontinue all claims of ASNT certification and must return all certificates and wallet cards issued by ASNT.1. and agreed to. investigation. The Level III shall conscientiously avoid conflict of interest with the employer or client. The “Level III” as referred to herein is that individual who has been issued a certificate by the American Society for Nondestructive Testing. Integrity 2. 8. or his/her associates’. The Level III shall not pay. he/she shall: 4. retained. 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. shall be honest and impartial. 8. or other tribunal. 2.1. unless the circumstances are fully disclosed to. and welfare of the public. 5. health. The Level III shall not to use their certification in a misleading manner or in such a manner as to bring ASNT into disrepute. or employed public official. and 3. Rulings of Other Jurisdictions Conviction of an NDT-related 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. upon a background of technical competence in the subject matter. 2. or arguments on nondestructive testing matters connected with public policy which are inspired or paid for by an interested party.3. Apprise the proper authority if it is evident that the safety. sanctions may be applied to the individual(s) in violation. health. the Ethics Committee. and 3. statement. or permit the use of. lead to fallacious inference.2. Any violation of this code shall be deemed to be an unauthorized practice and upon proper complaint. and welfare of the public in the performance of professional duties. 5.1. Inc. financial or otherwise.3. his/her name or firm name in a business venture by any person or firm which he/she knows. health. solicit.2. Undertake to perform assignments only when qualified by training and experience in the specific technical fields involved. the following rules of professional conduct shall be binding upon every person issued a certificate by ASNT as a Level III. or has reason to believe is engaging in business or professional practices of a fraudulent or dishonest nature. or reasonably could.1. unless he/she has prefaced the remark(s) by explicitly identifying himself/herself. 4. Such knowledge shall encompass the understanding that the practice of nondestructive testing under this certification is a privilege. interests. Solicitation of Employment 6.

asnt. 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. allow 3-4 months for delivery. Dues are nonrefundable. О Office Join now for immediate and significant savings on examination fees.for current volume Print and Electronic Subscription . a quarterly newsletter.asnt. Former Member: Phone О Yes О No ASNT membership keeps you informed of the latest in technology in addition to savings on certification provides publications and networking functions • Serve on ASNT committees. Be sure to complete the questions on the next page. Includes subscription to Materials Evaluation and The NDT Technician.I. be part of a group that may effect change or the industry ASNT membership includes: • 25% discount on all items purchased from our Publications Catalog or Shop ASNT online at www. Total Membership Amount $ Please enter total amount in membership box on page one and add to total. all materials will be sent sea/surface mail. О $55 О $55 О $75 Print Subscription . • Access to the largest network of NDT contacts and businesses worldwide • Materials Evaluation. Membership Options One-Year Two-Year Three-Year Five-Year Student.for current volume Electronic Subscription . app-liii-3 О $129 7 of 8 Rev 6/27/14 . All pricing subject to change. Stay informed throughout your certification period by maintaining membership along with your certification. Become part of the foremost nondestructive testing society and be fully connected to the NDT world. Save $75 per method.a savings of $35 О $149 For members outside North America: Unless airmail is specified. Do not miss out on subscribing to ASNT’s quarterly research journal.ASNT Individual Membership Application & Renewal Form Member Information Last Name First Name Send Membership Materials to: О Home M. Earn recertification points for ASNT membership. RNDE. the authoritative monthly journal on NDT • Local Section affiliation. One-Year Must submit transcript or letter or enrollment Military Rank E-5 or lower Renewing Member Dues О О О О О О Renewing Member Dues with Airmail Service included $65 $125 $180 $290 $15 $30 О О О О О О $113 $209 $294 $465 $63 $78 New Member Dues О О О О О О $75 $135 $190 $300 $15 $30 New Member Dues with Airmail Service included О О О О О О $123 $219 $304 $475 $63 $78 Research in Nondestructive Evaluation (RNDE®) Individual Subscription With Airmail Service Included RNDE® is ASNT’s quarterly research journal. 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 www.

Number of people involved with NDT at your company О1-5 О6-20 О21-50 О51-100 О over 100 О Aerospace/Aviation/Aircraft О Amusement Rides & Skiing О Automotive О Chemical & Petroleum О Construction О Commercial Labs О Infrastructure (Roads & Bridges) О Electronics О Marine NDT Supplier Business О Consulting О Distributor/Manufacturer's О Representative О Equipment О Research О О О О О О О О О Medical Nuclear Optical Ordnance Pipeline Pulp/Paper Railroad Semiconductor Utilities О О О О О Robotics Supplies Training Computer Software Computer Hardware 6.12 О High School Diploma О Some College О 2-Year Associate Degree О 4-Year Undergraduate Degree О Master's Degree О Doctorate Degree 4. 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 О О О О О О Magnetic Flux Leakage Magnetic Particle Neutron Radiography Radiography Ultrasonics Vibration Analysis Visual For Questions Contact the Membership Department at: Phone 614. Gender 9. Year of Birth 2. Highest Level of NDT qualification (select only one) I recommend/approve the purchase of: 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 8.2768 (US/Canada) 8 of 8 Rev 6/27/14 . best describes your role. Choose the one business segment that best describes your company. Choose the primary type of NDT that you do. (select only one) (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.274.Membership Profile 1.6003 app-liii-3 Toll Free 800. Purchasing Responsibility (select all that apply) 11. Years of Experience in NDT О1-5 О6-10 О11-15 О16-20 О21 & over 5. (select only one) О Male О Female NDT Utilization Business 3.222. Your Job Function . Plant/Operation Maintenance & Process Control О Consultant О Student О Product Life Extension О QA/QC Reliability О None of the above 7. Highest Education Level О Grades 1 .Choose the one that 10.