CWI 9th Year

8669 NW 36 St., #130 Miami, FL 33166-6672 Application

(800) 443-9353 or (305) 443-9353, ext. 273
Checklist Form
For your convenience, please use our Certification Application Portal.
Effective November 15th,2019, applications will be charged an additional non-refundable fee of $125.00 if sent to
AWS by email or paper.

Applicants Information:
Last Name: _____________________________ First Name: _________________________ Middle: ______________

Certification #: __________________________

Check sections for compliance. *Incomplete applications will not be processed.

Personal Information – Last, First, and Middle initial MUST be completed, including Certification number.
Sec. 1: Payment Information - Payment MUST accompany this application.
Sec. 2: Personal Information – Last, First, and Middle initial MUST be completed.
Sec. 3: Member Information and Certification number
Sec. 4: Recertification by Exam Option – if recertifying by exam and/or taking a Seminar, please check this option.
Sec. 5: Recertification by Non- Exam Option - if recertifying by non-exam, please check one option.
Sec. 6: Exam Location – Site Code (if Applicable), Exam Date, City/State, and Submission Deadline
Sec. 7: Proof of Identity – current color copy of government passport or national ID
Sec. 8: Associations – Type of Business, Job Classification and Technical Interests.
Sec. 9: American Disabilities Act (ADA): if applicable, candidate must print a copy of our ADA package and follow the
instructions. www.aws.org/ada-disability-accommodations
Sec. 10: Qualifying Work Experience - MUST be completed for each employer to meet minimum work experience
requirement. All fields are mandatory.
Sec. 11: Visual Acuity Form – Eye Examinations shall be performed not more than one (1) year prior to the date of
certification. Applicants shall submit results to the AWS certification department along with their application.
Sec. 12: Photo Requirement – To learn more, review the information on how to provide a suitable photo to avoid
processing delays by visiting our website www.aws.org/certification/page/photo-id-requirements
Sec. 13: Terms and Conditions - This section of the application must be read, checked, dated, and signed by the
applicant taking the exam.
Sec. 14: Continuing Education and/or Teaching Credit - Complete this section only if submitting 80 Personal Development
Terms
Hours.
For Exam Fees Certification Price List

Method of Payment - Payment must accompany this application AWS USE ONLY

Check if billing address is different from mailing

__________________________________________________________________
__________________________________________________________________ Acct #: ___________________________________

All checks and money orders made payable to AWS

Check or money order #_______________________
Date: ____________________________________
VISA MC AMEX Discover

CC#: / / / Exp: /
Amt$:_______________________________CWI
SIGNATURE :____________________________________________________________ CVV: ___________________

Recertification Application for CWI 9th Year_1108 Page 1 of 7 October 22, 2020
LAST NAME ______________________________ FIRST NAME __________________________________________

2. Personal Information Name must match your current government issued ID or Passport

Last Name First Name Middle Initial

Certification # Exp. Date AWS Member #

Street Address City, State, Zip Code

Home Telephone Work Telephone Mobile Telephone

Email Date of Birth MM/DD/YY Last Four Digits of

SS#

3. Member Information: Check and complete

Are you an AWS Member? Yes No If yes, please provide your Member #: ________________________ Company Membership not applicable.

What is your AWS CWI Certification number and Expiration: CWI #: ___________________________ Exp. Date: _______________________

4. Recertification Exam Options (choose, unless recertifying by a non-exam option):

CWI Part B- Practical Exam Only - Complete Sections 6 through 9 and 11 through 13.
Exam Only Seminar & Exam Part B Seminar & Exam Body of Knowledge

5. Recertification Non-Exam Options (choose one, unless recertifying by an exam option): Sample ✔

5a. 80 Professional Development Hours (PDHs) - Complete sections 7-14 and skip 9
5b. CRI Certification achieved prior to 9th year of CWI Certification (submit copy of certificate) - Complete sections 7 and 10 through 13
5c. Endorsement- Achieved prior 9th year of Certification (submit a copy of certificate) - Complete sections 7 and 10 through 13
5d. 9-year Recertification Course - Complete sections 6 through 7 and 10 through 13

6. Indicate exam location of your choice: Confirmation is emailed in 3-4 weeks from receipt of application. Exam Schedule
1st Site Code_________________ Date__________________ City/State __________________________ *Submission Deadline__________________________

2nd Site Code_________________ Date__________________ City/State___________________________ *Submission Deadline__________________________

3rd Site Code_________________ Date__________________ City/State___________________________ *Submission Deadline__________________________

NOTE: If the first choice is not available, registration will indicate the next available choice site. DO NOT make any hotel or flight arrangements until you have
received your exam confirmation letter from the Certification Department via email. Refer to AWS Policies and Fees.

7. Proof of Identity
Please check that you’ve attached a color copy of your current Government issued ID to this application, such as a driver’s license or
passport. This is required if testing for an endorsement exam through Prometric.

Recertification Application for CWI 9th Year_1108 Page 2 of 7 October 22, 2020
5. Associations
TYPE OF BUSINESS (CHECK ONLY ONE) Job Classification (check only ONE) Technical Interests (check ALL that apply)

A Contract Construction 01 ✔
President, owner, partner, officer
✔ Robotics
Computerization of Welding
B Chemicals & Allied products 02 Manager,Director,Superint.(or assistant)
Ferrous Metals
03 Sales
C Petroleum & Coal Industries Aluminum
04 Purchasing Nonferrous Metals Except Aluminum
D Primary Metal Industries
05 Engineer — welding Advance Materials/Intermetallics
E Fabricated Metal Products
Ceramics
06 Engineer — other
F Machinery Except Elect. (incl. Gas Welding) High Energy Beam Process
07 Inspector, tester Arc Welding
G Electrical Equip., Supplies, Electrodes
08 Supervisor, foreman Brazing & Soldering
H ✔ Transportation Equip. - Air, Aerospace
09 Welder, welding or cutting operator Resistance Welding
I Transportation Equip. - Automotive Thermal Spray
10 Architect, designer
J Transportation Equip. - Boats, Ships Cutting
11 Consultant NDT
K Transportation Equip. - Railroad
12 Metallurgist Safety & Health
L Utilities Bending & Shearing
13 Research & development
M Welding Distributors & Retail Trade Roll Forming
14 Technician Stamping & Punching
N Misc. Repair Services (incl. welding Shops)
15 Educator Aerospace
O Educational Services (Univ,Libraries,Schools)
Machinery
16 Student
P Engineering & Architectural Serv.(Incl.Ass.) Marine
17 Librarian Piping & Tubing
Q Misc. Business Services (Incl.Comm.Labs)
18 Customer service Pressure Vessels & Tanks
R Government (Federal,State,Llocal)
19 Other Sheet Metal
S Other Structures
20 Engineer - design Other
21 Engineer - manufacturing Automation
22 Quality Control Computerization of Welding

Page 3 of 7
Initial CAWI/CWI Exam Application 1101 October 23, 2019
Name: AWS Member #

9. American with Disabilities Act Accommodations

By checking this box I am requesting special accommodations due to a disability. AWS is committed to complying fully with
the ADA. Click here for a copy of the accommodations request package.

Will you be using a glucose meter during your exam? Yes No

10. Qualifying Work Experience – Resumes not accepted.

_______ I attest to having no period of continuous inactivity greater than two years during the previous three years of certification. I understand that work
(Initial)
experience documented on this application will be verified with both past and present employers.

Company Name Type of Business Company Phone Number

Company Street Address City, State, Zip Code

Supervisor’s Name Title of Immediate Supervisor

Supervisor’s Email Address Department

Applicant’s Job Title Employed From: To:

(Mo.) (Yr.) (Mo.) (Yr.)

Job Responsibilities- Detailed Description Required

DUPLICATE THIS SECTION FOR EACH ADDITIONAL EMPLOYER

11. Visual Acuity Form
A current Visual Acuity Form must be completed and submitted along with this application. To download a copy of the form,
please visit our website.

12. Photo Requirement

Applicants MUST submit one (1) passport-style color photograph. Your photo is a vital part of your application. To learn more,
review the information on how to provide a suitable photo to avoid processing delays by visiting our website. The acceptance of
your photo is always at the discretion of the AWS.
Print your name and AWS membership number on the reverse of the photograph.

DO NOT STAPLE OR PAPER CLIP PHOTO

Photos copied or digitally scanned from

driver’s licenses or other official
documents are not acceptable.

Only use scotch tape on

the back of the photo

Recertification Application for CWI 9th Year_1108 Page 4 of 7 August 14, 2019
13. Terms and Conditions- Please check, date, and sign below.

PROGRAM AND REGISTRATION TERMS, POLICIES, AND FEES

I hereby certify that I have read the program requirements contained in the following program document:
• QC1 Standard for the AWS Certification of Welding Inspectors
• B5.1 Specification for the Qualification of Welding Inspectors
Further, I agree to comply with the existing requirements and any subsequent requirements that may be instituted by AWS. I
have read and agree to the terms and conditions set forth in the AWS Policies and Fees form. I certify that the information I
have included on this application is true. I understand that any false statements will nullify this application. I give AWS
permission to verify this information. I agree to comply with the provisions set forth in the Standard concerning the
administration of my examination and certification. Upon obtaining my certification, I give AWS the right to reveal my
certification status as it relates to my validity and expiration date. I further understand that any required information that is
incomplete or missing will cancel this registration.

EXAMINATION POLICIES AND RULES

Furthermore, I certify that I have not obtained any exam materials, have no prior knowledge of the AWS exam questions or
answers, and have not and will not accept any solicitation for the AWS exam questions or answers from anyone at any time
before, during, or after the exam as stated on the Candidate Attestation Agreement (Please click and read this link prior to
accepting the Terms and Conditions. You will be required to sign this form on exam day). I understand that a violation of this
oath may be grounds for invalidation of my certification and may be grounds for expulsion from any future testing. AWS may
send text alerts regarding your seminar and/or exam site information or status.

COVID-19/COMMUNICABLE DISEASE LIABILITY POLICIES AND WAIVER

Furthermore, I certify that I have read and understand the COVID-19/Communicable Disease Liability Waiver requirements. I
certify that I understand that I will be asked to sign this waiver at the start of any AWS seminar, class, exam, or other AWS
event. I further understand that failing to agree to the pronouncements in the waiver will disqualify me from participating in
the event, and I will be barred from entering the event room or participating the event. I further understand that being barred
for failing to agree to the pronouncements will result in forfeiture of all registration fees. I understand that I will also be barred
from the event if I do not attest to both of the COVID-19 statements related to recent symptoms and exposure risks.

Applicant’s Signature ________________________________________________ Date: ___________________________

Initial CAWI/CWI Exam Application 1101 Page 5 of 7 Oct 22, 2020

Name: AWS Member #

14. Continuing Education and/or Teaching Credit

Complete this section only if submitting 80 Personal Development Hours, include certificate of completion and course
description and/or syllabus. Duplicate this page as necessary. For details regarding documentation of PDHs please refer to QC1
section 16.5. www.aws.org/library/doclib/QC1-2007.pdf#page=19#
Example:
Institution or provider name and contact information: Title of course or seminar:

Sample Institution Welding Technology 101

1234 Street
Anywhere, US 54321
PDH Phone: 999-555-1212
40 DATE OF COMPLETION: January 2, 2099

Institution or provider name and contact information: Title of course or seminar:

PDH
DATE OF COMPLETION:

Institution or provider name and contact information: Title of course or seminar:

PDH
DATE OF COMPLETION:

Institution or provider name and contact information: Title of course or seminar:

PDH
DATE OF COMPLETION:

Institution or provider name and contact information: Title of course or seminar:

PDH
DATE OF COMPLETION:

Recertification Application for CWI 9th Year_1108 Page 6 of 7 August 14, 2019
 Name: AWS Member #

VISUAL ACUITY FORM

Member #: _______________ Email address: __________________________________ Date:____________________

Last Name: ________________________________ First Name: ______________________________ MI:___________

Applicant
This form must be submitted for all SCWI/CWI/CAWI/CRI/CWEng applications ONLY.
AWS will not release exam results, recertification results, or renewals without a completed Visual Acuity Record on file.
IMPORTANT: This completed Visual Acuity Form must be sent to the AWS Certification Department along with the application. Applicants
who have not fulfilled all requirements and/or have not submitted the form, shall have test scores/application voided and may be in
jeopardy of forfeiting application fees. This form may be sent via email or mail.

Eye Examination
Eye examinations shall be administered by an Ophthalmologist, Optometrist, Medical Doctor, Registered Nurse or Certified Physician’s
Assistant or by other ophthalmic medical personnel and must include the state or province license number. Examinations shall be performed
not more than one (1) year prior to the date of the certification examination or the expiration date for renewals and recertifications. New
visual acuity records do not need to be supplied for retests occurring within one (1) year from the original examination date.

All applicants must pass an eye examination, with or without corrective lenses, to prove near vision acuity on Jaeger J2 at 12 in. or greater
(≥30.5 cm). All applicants shall take a color perception test. Eye examination results must be documented on this Visual Acuity Record form
supplied by the AWS Certification Department. No other forms will be accepted.

1. The following must be completed by the eye examiner:

A. Verify the customer’s close vision acuity to Jaeger J2 specifications at a distance of 12 inches or greater(≥30.5 cm) AWS Use
(Check ONLY one of the following for each eye) Only
OD OS
Requires corrected vision to read Jaegar J2 at 12 in. or greater. W
No correction is required to read Jaegar J2 at 12 in. or greater. O
Unable to read Jaegar J2 at 12 in. or greater even with attempt at correction. NQ
B. Through a color perception examination, is the applicant colorblind? AWS Use
(Check ONLY one of the following for each eye) Only
OD OS
Customer IS NOT colorblind C
Customer IS colorblind. B
3. Examiner’s Contact Information (print clearly)

Customer Name: Date of eye exam:

Examiner Name: Phone Number:
Examiner Address:
City: State: Zip/Postal Code: Country:
4. Examiner professional status (check only one)

Ophthalmologist Optometrist Medical Doctor Registered Nurse Certified Physician’s Assistant

Examiner Signature: State/Prov. License number:

Recertification Application for CWI 9th Year_1108 Page 7 of 7 August 14, 2019