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NDT-II app 1 of 8 Rev. 5/27/14

ASNT NDT Level IICertification Application ASNT Identification NumberIf you have previously been given an ASNT identification number, please enter it in this box:

Personal Data Mail certification information to: Home WorkMail membership material to: Home Work ___Mr ___Miss ___Mrs ___MsName

Last First Middle Init.

HomeAddress

City State/Prov. ZIP/Postal Code Country

Phone Fax Email

WorkOrganization Name

Address


Phone Fax Email

Fees All fees are in US dollars.

Examination Total From page 2 $

International Mailing Surcharge All non-US Residents must pay a $40.00 mailing surcharge $

Membership OptionTake advantage of ASNT member pricing now by completing themembership application on pages 7 and 8 and include that total here. $

Save on certification fees by becoming an ASNT member.See page 7 for all the benefits members enjoy.

Total Fees $

Less transfer in (if applicable-include copy of transfer letter) -$

Total Due $

PaymentPayment must accompany application Personal Credit Card Company Credit Card

CheckMoney Order

DiscoverVisa Card Holder’s Signature:

Funds Transfer MasterCard Card Holder’s Name (print):

Make the abovepayable to ASNT

(must be drawnon a US bank)

American Express Credit Card Number:

Credit Card Billing Address:

Expiration Date CIN* Number*CIN (Credit Card Identification Number): Visa/MasterCard/Discover: The three-digit number is printed on the signature panel on the back ofthe card following the account number. American Express: The four-digit number is printed above the account number on the front of the card.

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Examination Information Location and DatesSelect a location from the online ASNT Examination Schedule ( http://www.asnt.org/certification/schedules/index.htm ) and enter thelocation of the exam here. You may also choose to take your examination(s) at one ofASNT’S Authorized Examination Centers (AECs) or National Sponsoring Organizations(NSOs). If you are applying to take your examination at one of those sites, enter “AEC” orthe NSO site where you wish to examine. AECs and NSOs Centers charge additionaladministration fees; check with those organizations to learn those fees.

Scheduling and Fees, Initial CertificationASNT NDT Level II candidates applying for initial certification MUST take both the General examination AND a General IndustrySpecific examination for each test method in which certification is sought.

In the table below, check the boxes for the examinations you wish to take, enter the dates and times when you wish to take thoseexaminations and place the appropriate fee amount in the "Your Fees" column. When finished, total your fees and place them in theFees column on page 1 of the application.

Example:

An ASNT member wishing to be certified in MT in the General Industry Sector at an AEC would fill out the MT line as follows:

Method Examinations Requested ASNT MemberExam FeeNon-Member*

Exam FeeExamDate

Exam Time(AM or PM) Your Fees

MT General + GI Specific Exams $260.00 $335.00 $

Exam dates are listed in the ASNT Examination Schedule shown online at http://www.asnt.org/certification/schedules/index.htmExaminations for only one test method may be taken in each morning or afternoon session, with a maximum of two (2) examinationsper day at a scheduled test site. If you are applying to take your examination at an AEC, write “AEC” under “Date”. You will thenschedule the date and time of your examination directly with the AEC after you receive your Notification of Approval letter from ASNT.


Exam FeeExamDate


MTGeneral + GI Specific Exams $260.00 $335.00 $

PTGeneral + GI Specific Exams $260.00 $335.00 $

RT

General + GI Specific Exams $260.00 $335.00 $

UTGeneral + GI Specific Exams $260.00 $335.00 $

VTGeneral + GI Specific Exams $260.00 $335.00 $

Your Fee Total: $(Place this amount in the Exam Fees block on page 1)

Retakes and Industry Sector Add-OnsPersonnel retaking failed examinations or adding an Industry Sector should select their examinations from the table below. Initial certification candidates may NOT use this table; they should use the table above.


Exam FeeExamDate


MT General Specific: GI $130.00/exam $205.00/exam $PT General Specific: GI $130.00/exam $205.00/exam $RT General Specific: GI $130.00/exam $205.00/exam $UT General Specific: GI $130.00/exam $205.00/exam $VT General Specific: GI $130.00/exam $205.00/exam $

Your Fee Total: $(Place this amount in the Exam Fees block on page 1)

* You may take advantage of ASNT Member pricing now by becoming an ASNT member or renewing yourmembership with this application. An ASNT Membership application is attached on pages 7 & 8 of this application.

Location:

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Minimum Training RequirementsUse this table to find the minimum training required for ASNT NDT Level II certification in each method. Enter theamount of training you are claiming to meet the requirements.

Training MT PT RT UT VT

Hours Required 20 12 80 80 24

Hours Claimed

You must attach documentation for the minimum required amount of training required. Attach copies oftraining certificates, letters of completion, or company training records. A signed statement attesting to completionof training from a company executive, an individual responsible for training, or an ASNT Level III or ACCP™Professional Level III is also acceptable if it clearly lists training hours for each test method in which certification issought. All documentation must be in English or accompanied by an English translation.

Minimum Experience RequirementsThe table below lists the minimum experience required for ASNT NDT Level II certification in each test method.Enter the amount of experience you are claiming to meet the requirements. Use the next page to document theindividual positions in which experience was obtained.

Total hours in method experience shall be based on the actual hours worked in the specific method. Total hoursin method must be met for each method when applying for more than one method.

Experience MT PT RT UT VT

HoursRequired

Total Hoursin Method

280 210 840 840 210

Total Hoursin NDT

530 400 1600 1600 400

HoursClaimed

Total Hoursin Method

Total Hoursin NDT

If you do not satisfy the above criteria for the method(s) in which you are applying, please do not submit anapplication. Applications received from ineligible applicants will be returned to the applicant in accordance withthe 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 experienceappropriate for that examination. Do not rely on past applications to meet this requirement.

Recertifying and retaking personnel need only submit documentation for experience gained since the lastapplication.

NOTE: It is the responsibility of the employer to administer an eye test and a Practicalexamination in accordance with Recommended Practice No. SNT-TC-1A tocomplete certification to NDT Level II.

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Experience

Photocopy this page as necessary to list your experience history. If submitting experience from more than oneemployer, submit experience in reverse chronological order, beginning with your most recent employer in Position 1. TheASNT NDT Level II program requires sufficient NDT experience to meet the minimum experience requirements in themethod(s) for which you are applying. Acceptable documents include employer or third-party certificates or certificationrecords, human resources records, a signed statement from the employer or responsible Level III, a signed statementfrom an ASNT Level III or ACCP Professional Level III, or, for self-employed personnel, signed statements from at leasttwo (2) customers. The signature form below may be used for signed statements. All support documentation must be inEnglish or accompanied by an English translation.

Name First, Middle, Last ASNT ID

Position # _____ Dates of Employment: Start Date End Date Total Time (Months)

Organization Name

Organization Address


Phone Fax Email

Check methods below where NDT job functions were performed by the candidate named above and indicate the numberof hours claimed for each.

MT PT RT UT VTHours Hours Hours Hours Hours

Briefly describe below the NDT tasks the candidate named above performed at this location for each of the methodschecked. List the document(s) that are attached to this application as evidence of this engagement.

Statement OptionAs the above named candidate’s employer or a designated and responsible agent of the above named candidate’semployer or as a customer of the candidate, I confirm that the information given above is true and correct.

Employer/Agent/Customer Signature Date

Employer/Agent/Customer Name (print) ASNT ID # (if applicable)

Title

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Code of Ethics for NDT Level II Personnel Certified by ASNT1.0 Purpose

The following Code of Ethics is binding upon every individual whopossesses a current ACCP™ or ASNT NDT Level II Certification.These rules are necessary to protect the life, health, property andwelfare of the public, and to maintain the credibility of the ASNTCentral Certification Program, the ASNT NDT Level II program andthe NDT profession. Accordingly, each ACCP™ or ASNT NDTLevel II certified individual agrees to abide by the following:

2.0 Code of Ethics

2.1 Responsibility: Protect the safety, health and welfare of the public,by performing all NDT activities to the best of his/her ability inaccordance with properly established and approved procedures andonly in situations for which qualified.

2.2 Integrity: Perform all NDT activities honestly, and treat the public,clients and employer in an impartial and ethical manner. All reports

of NDT activities shall faithfully and accurately reflect the testsconducted, procedures used, and results obtained.

2.3 Conflict of Interest: Consciously avoid conflict of interest situationswith employer or client, promptly informing same if such situationscannot be avoided.

2.4 Improper Conduct: Refrain from work activities outside the area ofcertification without written approval of his/her supervisor.

2.5 Safety: Act in a safe and responsible manner while conductingNDT activities, ensuring that all required and necessary safetyprocedures are in place and are being used by one’s self and othersunder his/her jurisdiction.

3.0 Penalty

Violation of this Code of Ethics by any ACCP™ or ASNT NDT LevelII certificate holder may be cause for disciplinary action against thatperson which may result in sanctions up to revocation of ASNTcertification.

Statements and SignatureBy signature on this application, if certified by ASNT, I agree to abide bythe Code of Ethics for Level III Personnel Certified by ASNT so long as Imaintain a Certificate. Further, I understand the right of ASNT to

suspend or revoke any Certificate granted if I abuse the privilegestherein granted to me.

I understand that certifications which may result from this application donot constitute any form of license.

I hereby attest that all facts on this application are true and correct andno information which might be detrimental has been withheld. ASNT maymake any inquiries necessary to determine my qualifications forcertification. I agree to abide by the decision of ASNT relative to thegranting of any Certifications as applied for herein.

For valuable consideration, the undersigned, having made application forCertification as Level III before ASNT, does hereby release and foreverdischarge The American Society For Nondestructive Testing, an OhioCorporation, from any and all liabilities, claims, demands, or causes ofaction whatsoever, which now exist or which may hereafter arise onaccount of the undersigned’s activities henceforth as Level III certified byASNT.

The undersigned further acknowledges that this release is being given asa prerequisite for having filed application for consideration by ASNT.The undersigned further represents that if not certified by ASNT, thenthis release and discharge shall have no force and effect; otherwise,upon certification as set forth above, this release shall be binding on theundersigned and The American Society for Nondestructive Testing, Inc.

and any and all agents of ASNT in connection with such certificationprocess. I have read and understand the transfer, cancellation andrefund 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 infraudulent test-taking practices.

I understand that I am required to inform ASNT of matters that affect mycapability to continue to fulfill the requirements of my certification(s).Failure to do so may result in the suspension or revocation of mycertification(s) by ASNT.

I authorize ASNT to publish my name, city, state, country, test methods,levels, expiration dates of certification(s) and any possible suspension orrevocation of certification(s) by ASNT.

Signature of Applicant

Print Name of Applicant

Date

Transfer / Cancellation / Refund PolicyAll ASNT examinations are required to be taken within onecalendar year from the date on the original Letter of Notificationor Letter of Approval sent to the applicant. One transfer ispermitted within that year, subject to the administrative fees

detailed below. Failure to take examinations within that one-yearperiod will result in forfeiture of all fees to ASNT.

The transfer or cancellation deadline is two (2) calendar weeksprior to the week of a scheduled examination. Transfers orcancellations received before the deadline will be subject to a$75.00 administrative fee PER EXAMINATION. A transferringapplicant must remit those administrative fees to ASNT by theapplication deadline for the rescheduled examination. Noexamination attendance will be permitted unless all fees arepaid. Canceling applicants will receive a refund less alladministrative fees.

No transfers or cancellations will be accepted after the abovetransfer deadline. Failure to show up (“No Shows”) for scheduledexaminations will result in forfeiture of the fees for the missedexaminations.

If an examination application is received and the applicant isfound to be unqualified to take the examination, a refund will beissued less an administrative fee of $75.00 PER EXAMINATION.

All requests for transfers or cancellations must be submitted inwriting to ASNT and be signed by the person registered for theexamination. A signed fax transmittal is acceptable.

The International Surcharge and Membership / AdministrativeFees are non-refundable and non-transferable.

No exceptions will be made to the above policy.

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Submit Application

Mail

Mail this application, attachments, and fees to ASNT at:

ASNT1711 Arlingate LaneP.O. Box 28518Columbus, OH 43228-0518USA

Make checks payable to ASNT.

Fax

Or, if paying by credit card, you may fax this application,attachments, and fees to ASNT at:

614-274-6899

*** Please do not both mail and fax your application.***

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Membership app Page 7 of 8 Rev. 5/27/14

ASNT Individual Membership Application & Renewal FormMember Information

Last Name First Name M.I. Phone

Send Membership Materials to: Home Office Former Member: Yes No

Join now for immediate and significant savings onexamination fees. Save $75 per method.

Earn recertification points for ASNT membership.

Align with your certification period and consider joiningfor five years to receive maximum savings.

There is no better network for you to be connected when itcomes to your NDT career.

Stay informed throughout your certification period bymaintaining membership along with your certification.

ASNT membership keeps you informed of the latest intechnology in addition to savings on certification exams.

ASNT membership includes:• 25% discount on all items purchased from ourPublications Catalog or Shop ASNT online at www.asnt.org

Membership OptionsRenewal Member DuesTo qualify to pay as a renewing member, your membership expiration date mustbe within six months .

• Access to the largest network of NDT contacts and businessesworldwide

• Materials Evaluation, the authoritative monthly journal on NDT

• Local Section affiliation, provides educational and businessnetworking opportunities

• The quarterly newsletter for NDT practitioners:The NDT Technician

• Recertification points for membership

• Discounts on national conferences and symposiumregistration

• Members Only access at www.asnt .org provides publicationsand networking functions

• Serve on ASNT committees; be part of a group that may effectchange or the industry

Become part of the foremost nondestructive testingsociety and be fully connected to the NDT world.

New Member DuesNew members are those joining ASNT for the first time or members having more than asix month gap since expiration. Such rejoining members are subject to new member rate.

Renewal Member Dues *Dues with Airmail

Service included *New MemberDues

*Dues with AirmailService included

Dues include subscriptions toMaterials Evaluation andThe NDT Technician.

For members outsideNorth America: Unless airmais specified, all materials will besent sea/surface mail; allow 3-4months for delivery.

*Airmail service is restricted byavailability or cost; airmail maynot be offered to your country.You will be contacted if servicecannot be provided.

One-Year $65 $113 $75 $123 Two-Year $125 $209 $135 $219 Three-Year $180 $294 $190 $304 Five-Year $290 $465 $300 $475 Student, One-YearMust submit transcript or letter or enrollment $15 $63 $15 $63 Military Rank E-5 or lower $30 $78 $30 $78 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 AirmailService Included

Print Subscription - for current volume $55 $129 Add a subscription to ASNT’squarterly research journal,RNDE.

Electronic Subscription - for current volume $55 Print and Electronic Subscription - a savings of $35 $75 $149All pricing subject to change.

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.

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Membership Profile1. Year of Birth 9. Choose the one business segment that best

describes your company. (select only one)2. Gender Male Female

NDT Utilization Business3. Highest Education Level Aerospace/Aviation/Aircraft Medical

Grades 1 - 12 Amusement Rides & Skiing Nuclear High School Diploma Automotive Optical

Some College Chemical & Petroleum Ordnance 2-Year Associate Degree Construction Pipeline 4-Year Undergraduate Degree Commercial Labs Pulp/Paper Master's Degree Infrastructure (Roads & Bridges) Railroad Doctorate Degree Electronics Semiconductor

Marine Utilities4. Years of Experience in NDT NDT Supplier Business

1-5 6-10 11-15 16-20 21 & over Consulting Robotics Distributor/Manufacturer's Supplies

5. Number of people involved with NDT at Representative Trainingyour company Equipment Computer Software1-5 6-20 21-50 51-100 over 100 Research Computer Hardware

6. Your Job Function - Choose the one thatbest describes your role . (select only one)

10. Choose the primary type of NDT that you do. (select only one)

NDT Management Sales/Marketing Design and Failure Analysis Quality Management Researcher Field Inspection Engineer Academic/Educator Incoming Inspection Technician/Inspector Trainer/Instructor In-service, Plant/Operation Maintenance & Process Control Consultant Student Product Life Extension

QA/QC Reliability None of the above

7. Purchasing Responsibility(select all that apply) 11. Highest Level of NDT qualification

(select only one)I recommend/approve the purchase of: Equipment/Instruments/Supplies None ASNT NDT Level II Training & Study Materials/Programs Level I ASNT NDT Level III Services Level II ACCP Level II I am not involved in purchasing Level III ACCP Level III

IRRSP8. With which NDT method(s) do you work?

(select all that apply) Acoustic Emission Magnetic Flux Leakage Alternating Current Field Measurement Magnetic Particle

Electromagnetic/Eddy Current Neutron Radiography Ground Penetrating Radar Radiography Infrared & Thermal Ultrasonics Laser Vibration Analysis Leak Visual Liquid Penetrant

For Questions Contact the Membership Department at:Phone 614.274.6003 Toll Free 800.222.2768 (US/Canada)

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