Vous êtes sur la page 1sur 1

MAINTENANCEOFWELDERCERTIFICATION

$15,Maintenancefeemustaccompanythisform.(Pricesaresubjecttochange.)

LastName: EmailAddress:

FirstName:

MI:

S.S.#:XXXXX Certification#:

Enterthedateyoumostrecentlyusedtheprocessesyouwouldliketomaintain.

Important:Failuretoincludedatesbelowwillresultinpaymentbeingforfeited.

SMAW GTAW

GMAW Other

FCAW

Yourcertificationisextendedfromthedatesyouhaveindicatedabove.Ex:04/12/2012

Verification:/Employer/TestSupervisor/Customer:Certifythattheabovenamedwelderusedtheweldingprocess(es)onthedatesindicated. Important:ThisformisNOTtobesignedbytheapplicant.(PleaseCircleOne)

PrintName: Company: Signature:


Copythisformasneeded.

Title: Date:

Phone: ( )

Ifyourmailingaddresshaschangedinthelastsixmonths,pleaselistnewaddressbelow: NewAddress: City: Province/Country:

Apt./Ste.No.: State: ZipCode:

YOURCERTIFICATIONISIMPORTANTTOYOUANDTOUS!
Usetheseformsbeforeyourexpirationdatetoproperlymaintainyourcertification.Certificationsinaccordancewith SupplementCorD9.1fortheSheetMetalWeldingCoderequiremaintenanceevery12months.Certificationsin accordancewithD1.1andallothercodesrequiremaintenanceevery6months.Checktherequirementsofthestandard thatgovernsyourcertificationtoassurethatmaintenanceisreceivedbyAWSattheproperintervals.Allchecksand AWS,8669 8669Doral DoralBoulevard, Boulevard Suite 130, Doral, Florida moneyordersmustbemadepayabletoAWSandmailedto:AWS, Doral, Florida 33166 . 33166.

WERECOMMENDSENDINGYOURFORMVIAUSMAILRETURNRECEIPTREQUESTED.

MethodofPayment
Check#:

Visa

MasterCard

AmericanExpress

DinersClub

Discover

CreditCard#: Signature:

Exp.Date:

AWSUseOnly
DateReceived: Account#:

Amount:

CertMaintenanceofWelderCertification09/20/12