Australian Institute for Non-destructive Testing

PO Box 52, Parkville, Victoria 3052

Federal Office Phone: (03)9328 8831 Fax: (03) 9328 8787
Website: www.aindt.com.au Email: federaloffice@aindt.com.au

Application for Exemption / Special Consideration

Applicant Name: Date of Birth:

Email: Phone:

Membership Number: Certification Number:

Exemption / Consideration Sought: Where applicable, specific reference to the clause or reference in the AINDT
guide to certification must be included.

Reason/Extenuating Circumstances:

I understand that false or misrepresentation of status/details would be considered a breach of the AINDT code
of ethics
Signed: Date:

AINDT OFFICE USE ONLY

Reviewer Name:
Reviewer Position:
Approval Status: Include Full Details

Conditions: Expiry Date etc

Signed: Date:

NDT116.DOC_-_ Application for Special Consideration_2018_issue_1_rev_1 Issue_1_Rev1 2018 1