ASNT Level IIICertification ApplicationFor ChSNDT, ChinaASNT Identification NumberIf you have previously been given an ASNT identification number, please enter it in this box:Personal Data Mail certification information to: Home Work ___Mr ___Miss ___Mrs ___Ms NamePrint your name as you would like it to appear on your certificate. (First, Middle or Middle Initial, Last)HomeAddressCity State/Prov. ZIP/Postal Code CountryPhone Fax EmailWorkOrganization NameAddressCity State/Prov. ZIP/Postal Code CountryPhone Fax EmailFees All fees are in US dollars.Save on certification fees by becoming an ASNT member. See page 7 for all the benefits members enjoy. Basic Examination Total From page 2Method Examination Total From page 2International Mailing Surcharge Add for all Non-US Residents $40 Membership Option Take advantage of member pricing now by completing the membershipapplication on pages 7 and 8 and include the total here.Total FeesLess transfer in (if applicable-include copy of transfer letter)-Total Due PaymentPayment must accompany application Personal Credit Card Company Credit CardCheckMoney Order DiscoverVisaCard Holder’s Name(please print)Funds Transfer MasterCard Credit Card Billing AddressAmerican Express Card NumberMake payableto ASNT(must be drawn on a US bank)Expiration Date CIN Number* Card Holder’s Signature Date*Credit Card Identification Number: Visa/MasterCard/Discover: The three-digit number is printed on the signature panel on the back of the card following the account number. American Express: The four-digit number is printed above the account number on the front of the card.Examination SchedulingThis application is valid only for ASNT examinations held by The Chinese Society for Nondestructive Testing . Use the tables below to designate the examinations you would like to take. Please observe the application deadline date for the examination location and dates you are choosing. All exams are conducted in the English language.Note: This application is valid for initial certification and for recertification by examination. To renew without further examination (by points), you must use the ASNT Level III Renewal Application.Location and DatesTo apply for an exam, enter the date and time when you’d like to take the exam. Exam dates are listed in the ASNT Examination Schedule. Only one examination may be taken in a session. You may take a maximum of two (2) examinations per day at a scheduled test site.Check a box indicating if this is a new or added method, a retake of an exam that you failed within the last five years, or a recertification exam if you are currently certified in the method. Basic ExaminationsTo become certified as an ASNT NDT Level III, the NDT Basic examination and at least one Method examination must be passed.First time applicants must take the Basic and at least one Method examination. Once certification is achieved, additional methods may be added without retaking the Basic examination. If all certifications lapse, the Basic examination and the Method examination(s) must be retaken to regain certification.Method Examinations**You may take advantage of ASNT Member pricing now by becoming an ASNT member or renewing your membership with this application.Location: Shanghai, ChinaApplication Deadline: May 17, 2016 Exam Dates: August 9-12, 2016Education & Experience RequirementsASNT 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, 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), as defined in ASNT’s Recommended Practice No. SNT-TC-1A, latest edition;OR•Completed with passing grades at least two full academic school years of engineering or a physical science study at a university, college, or technical school, 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, latest edition; 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), as defined in ASNT’s Recommended Practice No. SNT-TC-1A, latest edition.If you do not satisfy the above criteria for the method(s) in which you are applying, please do not submit an application. Applications received from ineligible applicants will be returned to the applicant in accordance with the 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 experience appropriate for that examination.Do not rely on past applications to meet this requirement. Recertifying and retaking personnel need only submit information new since the last application.EducationYou must attach documentation for education if you are using post-secondary education to meet the Education and Experience Requirements. Copies of diplomas or transcripts are acceptable. All documentation must be in English or accompanied by an English translation.ExperiencePhotocopy this page as necessary to list your experience history. 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. The Statement Option form at the bottom of this page is acceptable as documentary evidence of work experience.If Statement Option below is not completed by employer/customer, you will need to submit other documentation supporting your work experience.Acceptable (other) documentation can include; employer or third-party certificates or certification records, human resources records, a signed statement from the employer or responsible Level III, a signed statement from an ASNT Level III or ACCP Professional Level III, or, for self-employed personnel, signed statements from at least two (2) customers. III or ACCP Professional Level III, or, for self-employed personnel, signed statements from at least two (2) customers. All documentation must be in English or accompanied by an English translation.Other supporting documents MUST state:1. Level of qualification or Level II job duties2. Number of months working Level II or comparable of that of a Level IIOther supporting documents that are NOT accepted:1. Certificate of Training /Non-employer issued qualifications2. Level I certificatesName__________________________________________________________________________ First, Middle, Last ASNT IDPosition # Dates of EmploymentStart Date End Date Total Time (Months) Organization NameOrganization AddressCity State/Prov. ZIP/Postal Code CountryVerify experience (write # of months performing work with Level II qualifications) by method as related to above employer.AE __ # of months IR __ # of months LT __ # of months RT __ # of months ML __ # of months VA __ # of monthsET __ # of months NR __ # of months PT __ # of months UT __ # of months MT __ # 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. 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’s employer or as a customer of the candidate, I confirm that the information given above is true and correct.Supervisor / Agent / Human Resource (Name - Signature) Today’s DateSupervisor / Agent / Human Resource (Name - Print) Work Email AddressJob Title - Position ASNT ID # (if applicable)Transfer / Cancellation / Refund PolicyAll 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. One transfer is permitted within that year, subject to the administrative fees detailed below. Failure to take examinations within that one-year period will result in forfeiture of all fees to ASNT.The transfer or cancellation deadline is two (2) calendar weeks prior to the week of a scheduled examination. Transfers or cancellations received before the deadline will be subject to a $75.00 administrative fee PER EXAMINATION. A transferring applicant must remit those administrative fees to ASNT by the application deadline for the rescheduled examination. No examination attendance will be permitted unless all fees are paid. Canceling applicants will receive a refund less all administrative fees. No transfers or cancellations will be accepted after the above transfer deadline. Failure to show up (“No Shows”) for scheduled examinations will result in forfeiture of the fees for the missed examinations.If an examination application is received and the applicant is found to be unqualified to take the examination, a refund will be issued less an administrative fee of $75.00 PER EXAMINATION.All requests for transfers or cancellations must be submitted in writing to ASNT and be signed by the person registered for the examination. A signed fax transmittal is acceptable.The International Surcharge and Membership / Administrative Fees are non-refundable and non-transferable.No exceptions will be made to the above policy.Statements and SignatureBy signature on this application, if certified by ASNT, I agree to abide by the Code of Ethics for Level III Personnel Certified by ASNT so long as I maintain a Certificate. Further, I understand the right of ASNT to suspend or revoke any Certificate granted if I abuse the privileges therein granted to me.I understand that certifications which may result from this application do not constitute any form of license.I hereby attest that all facts on this application are true and correct and no information which might be detrimental has been withheld. ASNT may make any inquiries necessary to determine my qualifications for certification. I agree to abide by the decision of ASNT relative to the granting of any Certifications as applied for herein.For valuable consideration, the undersigned, having made application for Certification as Level III before ASNT, does hereby release and forever discharge The American Society For Nondestructive Testing, an Ohio Corporation, from any and all liabilities, claims, demands, or causes of action whatsoever, which now exist or which may hereafter arise on account of the undersigned’s activities henceforth as Level III certified by ASNT.The undersigned further acknowledges that this release is being given as a prerequisite for having filed application for consideration by ASNT.The undersigned further represents that if not certified by ASNT, then this release and discharge shall have no force and effect; otherwise, upon certification as set forth above, this release shall be binding on the undersigned and The American Society for Nondestructive Testing, Inc. and any and all agents of ASNT in connection with such certification process. I have read and understand the transfer, 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.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). Failure to do so may result in the suspension or revocation of my certification(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 or revocation of certification(s) by ASNT.Signature of ApplicantPrint Name of ApplicantToday’s DateSubmit ApplicationMailMail this application, attachments, and fees to ASNT at: The Chinese Society for Nondestructive Testing100 Hui He RoadShanghai, 200437ChinaE-mail: chsndt@ and chsndt2008@ Make checks payable to ASNT.Please do not both mail and fax your application.Code of Ethics for Level III Personnel Certified by ASNT1. Preamble1.1. In order to safeguard the life, health, property, and welfare of thepublic, to maintain integrity and high standards of skills and practicesin the profession of nondestructive testing, the following rules ofprofessional conduct shall be binding upon every person issued acertificate by ASNT as a Level III.1.1.1. The Level III who holds a certificate is charged with havingknowledge of the existence of the reasonable rules andregulations hereinafter provided for his/her conduct as ASNTLevel III, and also shall be familiar with their provisions andunderstand them. Such knowledge shall encompass theunderstanding that the practice of nondestructive testingunder this certification is a privilege, as opposed to a right,and the Level III shall be forthright and candid in statementsor written responses to the Ethics Committee of theCertification Management Board.1.1.2. The “Level III” as referred to herein is that individual who hasbeen issued a certificate by the American Society forNondestructive Testing, Inc. pursuant to its heretoforepublished requirements, rules, and procedures for suchcertification. This Code of Ethics is binding upon allindividuals so certified.2. Integrity2.1. The Level III is obligated to act with complete integrity in professionalmatters for each client or employer as a faithful agent or trustee; shallbe honest and impartial; and shall serve the public, clients, andemployer with devotion;2.2. The Level III shall make claims regarding certification only withrespect to the scope for which certification has been granted; and2.3. The Level III shall not to use their certification in a misleading manneror in such a manner as to bring ASNT into disrepute, nor to makeany statement regarding the certification which ASNT may considermisleading or unauthorized.3. Responsibility to the PublicThe Level III shall:3.1. Protect the safety, health, and welfare of the public in theperformance of professional duties. Should the case arise where theLevel III faces a situation where the safety, health, and welfare of thepublic are not protected, he/she shall:3.1.1. Apprise the proper authority if it is evident that the safety,health, and welfare of the public are not being protected; and3.1.2. Refuse to accept responsibility for the design, report, orstatement involved; and3.1.3. If necessary, sever relationship with the employer or client;and3.1.4. Undertake to perform assignments only when qualified bytraining and experience in the specific technical fieldsinvolved. In the event a question arises as to thecompetence of an Level III to perform an assignment in afield of specific discipline which cannot be otherwise resolvedto the Ethics Committee’s satisfaction, the Ethics Committee,either upon request of the Level III, or by its own volition,may require him/her to submit to an appropriate inquiry by oron behalf of the Ethics Committee; and3.1.5. Be completely objective in any professional report,statement, or testimony, avoiding any omission which would,or reasonably could, lead to fallacious inference, finding, ormisrepresentation; and3.1.6. Express an opinion as a technical witness before any court,commission, or other tribunal, only when such opinion isfounded upon adequate knowledge of the facts in issue,upon a background of technical competence in the subjectmatter, and upon an honest conviction of the accuracy orpropriety of the testimony.4. Public Statements4.1. The Level III will issue no statements, criticisms, or arguments onnondestructive testing matters connected with public policy which areinspired or paid for by an interested party, or parties, unless he/shehas prefaced the remark(s) by explicitly identifying himself/herself, bydisclosing the identities of the party, on whose behalf he/she isspeaking, and by revealing the existence of any pecuniary interesthe/she may have in these matters.4.2. The Level III will publicly express no opinion on a nondestructivetesting matter unless it is founded upon adequate knowledge of thefacts in issue, upon a background of technical competence in thesubject matter, and upon honest conviction of the accuracy andpropriety of the testimony. 5. Conflict of Interest5.1. The Level III shall conscientiously avoid conflict of interest with theemployer or client, but when avoidable, shall forthwith disclose thecircumstances to the employer or client.5.2. The Level III shall promptly inform the client or employer of anybusiness associations, interests, or circumstances which couldinfluence his/her judgment or the quality of services to the client oremployer.5.3. The Level III shall not accept compensation, financial or otherwise,from more than one party for services on the same project, or forservices pertaining to the same project, unless the circumstances arefully disclosed to, and agreed to, by all interested parties or their dulyauthorized agents.5.4. The Level III shall not solicit or accept financial or other valuableconsideration from material or equipment suppliers for specifyingtheir products.5.5. The Level III shall not solicit or accept gratuities, directly or indirectly,from contractors, their agents, or other parties dealing with the clientor employer in connection with work for which he/she is responsible.5.6. As an elected, retained, or employed public official, the Level III (inthe capacity as a public official) shall not review or approve work thatwas performed by himself/herself, or under his/her direction, onbehalf of another employer or client.6. Solicitation of Employment6.1. The Level III shall not pay, solicit, nor offer, directly or indirectly, anybribe or commission for professional employment with the exceptionof payment of the usual commission for securing salaried positionsthrough licensed employment agencies.6.2. The Level III shall seek professional employment on the basis ofqualification and competence for proper accomplishment of work.6.3. The Level III shall not falsify or permit misrepresentation of his/her, orhis/her associates’, academic or professional qualification. He/sheshall not misrepresent or exaggerate the degree of responsibility in orfor the subject matter of prior assignments.6.4. Brochures or other presentations incident to the solicitation ofemployment shall not misrepresent pertinent facts concerningemployers, employees, associates, joint ventures, or pastaccomplishments with the intent and purpose of enhancingqualifications and work.7. Improper Conduct7.1. The Level III shall not sign documents for work for which he/she doesnot have personal professional knowledge and direct technicalsupervisory control and responsibility.7.2. The Level III shall not knowingly associate with, or permit the use of,his/her name or firm name in a business venture by any person orfirm which he/she knows, or has reason to believe is engaging inbusiness or professional practices of a fraudulent or dishonestnature.8. Unauthorized Practice8.1. Any violation of this code shall be deemed to be an unauthorizedpractice and upon proper complaint, investigation, due processhearing and ruling of the Ethics Committee of the ASNT CertificationManagement Council in accordance with procedures heretoforeestablished and published, sanctions may be applied to theindividual(s) in violation.8.2. If the applied sanction is suspension or revocation of certification, thecertificate holder agrees to discontinue all claims of ASNTcertification and must return all certificates and wallet cards issued byASNT.9. Rulings of Other JurisdictionsConviction 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 begrounds for a charge of violation of this Code.ASNT Individual Membership Application & Renewal Form Member InformationLast Name First Name M.I. Phone Send Membership Materials to: ОHome ОOffice Former Member: ОYes ОNoJoin now for immediate and significant savings on examination fees. Save $75 per method.Earn recertification points for ASNT membership.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.Stay informed throughout your certification period by maintaining membership along with your certification.ASNT membership keeps you informed of the latest in technology in addition to savings on certification exams.ASNT membership includes:• 25% discount on all items purchased from our Publications Catalog or Shop ASNT online at • Access to the largest network of NDT contacts and businesses worldwide• Materials Evaluation, the authoritative monthly journal on NDT• Local Section affiliation, 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 provides publications and networking functions• Serve on ASNT committees; be part of a group that may effect change or the industryBecome part of the foremost nondestructive testing society and be fully connected to the NDT world.Membership Options RenewingMember DuesRenewing MemberDues with AirmailService includedNew Member Dues New MemberDues with AirmailService includedOne-Year О$65О$113О$75О$123 Two-Year О$125О$209О$135О$219 Three-Year О$180О$294О$190О$304 Five-Year О$290О$465О$300О$475 Student, One-YearMust submit transcript or letter or enrollmentО$15О$63О$15О$63 Military Rank E-5 or lower О$30О$78О $30О$78 Research in Nondestructive Evaluation (RNDE®) Individual SubscriptionRNDE® is ASNT’s quarterly research journal.With Airmail Service IncludedPrint Subscription - for current volume О$55О $129 Electronic Subscription - for current volume О$55Print and Electronic Subscription - a savings of $35 О$75О $149All pricing subject to change.Dues are nonrefundable, nontransferable. Includes subscription to Materials Evaluation and The NDT Technician, a quarterly newsletter. For members outside North America: Unless airmail is specified, all materials will be sent sea/surface mail; allow 3-4 months for delivery.Do not miss out on subscribing to ASNT’s quarterly research journal, RNDE.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.Membership Profile1. Year of Birth 9. Choose the one business segment that bestdescribes your company. (select only one)2. Gender О Male О FemaleNDT Utilization Business3. Highest Education LevelОAerospace/Aviation/AircraftОMedicalОGrades 1 - 12 ОAmusement Rides & SkiingОNuclearОHigh School Diploma ОAutomotiveОOpticalОSome College ОChemical & PetroleumОOrdnanceО2-Year Associate Degree ОConstructionОPipelineО4-Year Undergraduate Degree ОCommercial Labs ОPulp/PaperОMaster's Degree ОInfrastructure (Roads & Bridges)ОRailroadОDoctorate Degree ОElectronicsОSemiconductorОMarineОUtilities4. Years of Experience in NDT NDT Supplier BusinessО1-5 О6-10 О11-15 О16-20 О21 & overОConsulting ОRoboticsОDistributor/Manufacturer's ОSupplies5. Number of people involved with NDT at ОRepresentative ОTrainingyour company ОEquipment ОComputer Software О1-5 О6-20 О21-50 О51-100 Оover 100ОResearch ОComputer Hardware6. Your Job Function - Choose the one that best describes your role. (select only one) 10. Choose the primary type of NDT that you do. (select only one)ОNDT Management ОSales/Marketing ОDesign and Failure AnalysisОQuality Management ОResearcher ОField InspectionОEngineer ОAcademic/Educator ОIncoming InspectionОTechnician/Inspector ОTrainer/Instructor ОIn-service, Plant/Operation Maintenance & Process Control ОConsultant ОStudent ОProduct Life ExtensionОQA/QC ReliabilityОNone of the above7. Purchasing Responsibility(select all that apply) 11. Highest Level of NDT qualification(select only one)I recommend/approve the purchase of:ОEquipment/Instruments/Supplies ОNone ОASNT NDT Level III ОTraining & Study Materials/Programs ОLevel I ОACCP Level IIОServices ОLevel IIОACCP Level IIIОI am not involved in purchasing ОLevel IIIОIRRSP8. With which NDT method(s) do you work?(select all that apply)ОAcoustic Emission ОMagnetic Flux LeakageОAlternating Current Field Measurement ОMagnetic ParticleОElectromagnetic/Eddy Current ОNeutron RadiographyОGround Penetrating Radar ОRadiographyОInfrared & Thermal ОUltrasonicsОLaser ОVibration AnalysisОLeak ОVisualОLiquid PenetrantFor Questions Contact the Membership Department at:Phone 614.274.6003 Toll Free 800.222.2768 (US/Canada)。