TWI enrolment form

PLEASE SE D APPLICATION WITH YOUR PAYMENT A D THE 'ECESSARY ENCLOSURES TO: Please tick: Self - Sponsored

TWI Training & Examination Services

TWI Middle East FZ - LLe Knowledge Village. Block 8. Office no. 114/11 5 P.D. Box 50293/. Dubai, UAE Tel: +97/43643010//2//4 Fax: + 97/ 4 367 8435 E-mail: deedar.shah@twime.com;lorna.cal-orti=@twime.com

Company

Sponsored

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General I. 2.

3.

documentation required from everyone Payment or company order no. Two passport photos with name clearly printed on the back (please do not staple to form) Vision certificate

PLEASE USE CAPITAL LETTERS THROUGHOUT Personal Information: In the event of cancellation by you, the event fee and the accommodation fee (if applicable) will be returned less a cancellation charge of 20%. If less tban 14 days notice is given by you, TWI reserves tbe rigbt to retain the whole fee. TWI reserves the right to cancel the event in case of insufficient registration or illness of lecturers. TWI will ensure maximum possible notice is given to the attendees and reserves the right to substitute lecturers and modify the course details as required.

TWI Candidate ID Number: (if taken other examinations with TW1) Course ref Course title

WI55 COlA"

Course date IMELDIOIG

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METHODS
Candidate's family name

OF PAYMENT

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Candidate's given name (s)

Full payment and/or Company Order no. must accompany this booking form. Bookings received without payment/order number will be treated as provisional which does not guarantee a place. Cheque Bank Draft Cash made payable to TWI Middle East FZ - LLC. HSBC Bank Middle East Ltd . P.O. Box 66, Dubai, UAE. Account no. 021 218367001, Swift: BBME AEAD OR Credit CardlDebit Card (Please Indicate if Company Card) YES 0

NIDHlDI KISH8DI
Date of birth (dd/mrn/yy) ermanent private address

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(home country address)

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Three digit security code _ _ Valid from & Expiry date Issue Number

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INDIA

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Postcode Private tel no E-mail

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Name (as it appears on card)

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address

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House number and postcode of card holder:

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(if different from above)

Correspondence

Signature of card holder OR Company order no

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Approving Manager's name_=--L_A_N_61-,--o_"_A_N_ ...:p Title

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SPONSOR'S
Date:

SIGNATURE:

03-02. 201\
in week commencing

Iwould prefer an examination

Sponsoring Company and Address

612'(9; 2011 VESSELS

(we will do our best to meet your requirements, offer alternatives) but reserve the right to

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name

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Where did you hear about TWI Ltd?

E-mail corrtc.ci ti2-iec.bnoFUtUYCl Q Please tick if you are - A member of The Welding & Joining Society - An ernplovee of an Industrial Member ofTWI Do you have a disability or any special needs relevant to this course or examination? Yes 0 No. If yes, please require. provide details of any adjustments you may

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TWI Training website Bulletin / Connect BINDT Publications

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TWI Training newsletter NDTCabin Other

Internal Use Only Booking Ref:

Examination

Applied For (to be completed

in full by all applicants)

I
In', t1C\I
C51rJIP

TRA05/EX08

Doc I Rev 15 - Page 2

of 3

Examination Type: Initial, supplementary, renewal, bridging or retest of a previously failed examination Examination Body: CSWIP, PCN, AWS, ASNT, BGAS PCN or BGAS Approval Number: Current CSWIP qualifications held: NOT Method (please circle)

MT RPS

PT LRUT

RT PAUT

ET

Rl AUT

UT ACFM

VT

BRS TOFD

Industry Sector: Aerospace, Welds, Wrought, Railway, General Categories: Level 1 Welding Inspection (please circle)
AWS/CSWIP

Level 3.2.1 Sunervisor 3.3U 3.4U

Level 3.2.2 Instructor OGI ASCA

CSWIP/AWS

Endorsement Concrete

Underwater Inspection: (please circle) Please contact TWI for the relevant EX07 document Plastics: Please contact TWI for the relevant EX07 document

3.lU

3.20

To be completed by all applicants applying to attend CSWIP Welding Inspection ExaminationsI confirm that I have read and comply with the pre examination entry requirements as laid down in the CSWIP Requirement Documents DOCUMENT No. CSWlP- Wl-6-92, lOth Edition January 20 II and understand that any fraudulent claim may result in the retraction of any certificate issued. Please tick the appropriate employer/third party box and give a detailed statement of how you meet the requirements, this must be signed and verified by an

Visual Welding Inspector (Levell)

Although there is no specific experience requirement it is recommended that candidates possess a minimum of six months' welding related engineering experience and two years industrial experience.

Velding Inspector (Level 2)

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Welding Inspector for a minimum of3 years with experience related to the duties and responsibilities listed in Clause 1.2.2 under qualified supervision, independently verified. Certified Visual Welding Inspector (Level I) for a minimum of2 years with job responsibilities in the areas listed in 1.2.1 and 1.2.2. Welding Instructor or Welding Foreman/Supervisor for a minimum of5 years.

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Senior Welding Inspector Welding (Level 3) Inspector (Level 2) for a minimum of2 years with job responsibilities listed in Clause

TRA05IEX08 Doc I Rev I5 - Page 3 of 3

Certified

in the areas listed in 1.2.1, 1.2.2 and 1.2.3. 1.2.3,

5 years' authenticated experience independently verified.

related to the duties and responsibilities

Welding

QC Co-ordinator A current valid CSWIP 3.2 Senior Welding Inspector responsibilities or an international equivalent. A current valid CSWIP 3.1 Welding international equivalent. Inspector certification plus three years documented experience related to the duties and

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with 10 year's documented

experience

related to the duties and responsibilities

or an

NDT Pre-certification experience Please list your specific experience and duration as required by the scheme documentation and attach copies of log book entries if available for NOT examinations, this is not a pre-requisite for examination, however certification will not be awarded until the experience is gained and evidence provided. This experience must be verified by your employer or a recent major client:

Verifier ame (in capitals): 'TEe HI'lQ fl1I\.)\V\ 'j)QESS0J2.E. Company: Position: \'v'\I'INf\UtINOJ "DIRI:C-ioR Telephone no.: Email Address: Date:
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vESSEL>

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the best of my belief, the candidate's statement given above is correct at the time of signing
or equivalent):

CANDIDATE - PLEASE NOTE I understand that TWI Ltd and its associated trading companies (and companies, organisations, or agents processing data on its behalf) will hold and use personal data supplied by me for administration purposes. These purposes have been notified under the Data Protection Act 1998. The data may also be used to send separate unsolicited mailings containing details of events, new services, products etc. You have the right to ask TWI Ltd NOT to send such mailings. If you do not wish to receive this information from TWI Ltd, please tick this box . You have the right of access to personal data that we hold about you, on payment of the access fee not exceeding 10. Requests should be addressed to The Data Controller, TWI Ltd, Granta Park, Gt Abington, Cambridge CB21 6AL, UK. I agree to read the Health & Safety and Security information provided by TWI and to abide by the guidance given. I understand that occasionally images of training and examinations are taken by TWI for publicity and other purposes and that permission for my inclusion in such material is implied unless I make it known to Customer Services at registration that I do not wish to feature. I have read and understood the documentation issued by the scbeme management that is relevant to tbe examination for which I am applying and declare that I satisfy those criteria covering vision, training and experience. I accept responsibility for any examination fees in the event of non-payment by the sponsor. I agree to abide by the requirements for certification as relevant to tbe examination for which I am applying. In particular I agree to comply, if applicable, with the CSWIP rules on use and misuse of certificates and on professional conduct (see www.cswip.com). I understand that any appeal against an exam result must be received within six months of the exam date. I have read the listing and include all the requested information. I understand that any false statement may result in the examination being invalidated.

CANDIDATE SIGNATURE: