ACCP Application for Level II

and Level III JIS Z 2305

Certificate Holders
ASNT Identification Number
If you have previously been given an ASNT identification number, please enter it in this box:

Personal Data Mail certification information to:

Home

Work

Name
Print your name as you would like it to appear on your certificate: First, Middle or Middle Initial, Last

Home
Name of the building, house number, street, town/village

City

Prefecture/State/Province.

Postal Code

Phone

Fax

Email

City

State/Prov.

ZIP/Postal Code

Phone

Fax

Email

Country

Work
Organization Name

Address

Certifications Requested

Country

(check the boxes below to show which ACCP certifications are being requested)

NOTE: If the Pressure Equipment (PE) Sector is being requested, you must complete the PE Sector Experience Section on page 3.

Level II:
Test
Method

Industry Sector
(Select one or both)

Techniques
(Mark each Technique for which certification is sought)

MT

GI

PE

Yoke

Bench

PT

GI

PE

Solvent-Removable

Water-Washable

RT

GI

PE

X-Ray Only

X-Ray & RAM

UT

GI

PE

Welds Only

Castings/Forgings

Post-Emulsifiable

Level III:
Industry Sector
(Select one or both)
GI

Test Methods
(Level IIIs must be certified in all Techniques in each Test Method selected)
MT

PE

PT

RT

UT

Fees (All fees are listed in US dollars)

Certification Fee:
Mailing Surcharge:
Membership
Option:

(See page 2 to calculate your Certification Fee then place it here:)

$
$40.00

For all Non-US Residents (to cover International Mailing charges)

You can save on certification fees by becoming an ASNT
member. Complete the membership application on pages
8 & 9 and include the membership fee total here:

Fee Total:

Payment
Payment is to be submitted to the Japanese Society for Nondestructive Inspection (JSNDI) in a form suitable to JSNDI.
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Certification Fees
ACCP Level II
ACCP Level II certification fees are made up of three items: an Application fee, the Technique fee and an International Surcharge. The
Application fee is a fixed fee that is charged once per application. The Technique fee is based on the number of NDT Techniques
selected and whether or not you are a current ASNT Member. The International Surcharge is applied to all non-US residents to cover
the additional cost of international mailings.
To determine your Certification Fees, do the following:
1) Count the number of Techniques you applied for in the Certifications Requested table on page 1;
2)

If you are a current ASNT member, multiply that number by $50.00: _______Techniques x $50.00 =

3)

If you are NOT an ASNT member, multiply that number by $125.00:

_______Techniques x $125.00 =

NOTE: If you are not currently an ASNT Member, you can fill out the membership
application on pages 8 & 9, then take advantage of the ASNT Member pricing.
4)

Place the amount from the appropriate box above and place that amount in the table below as your Technique Fees;

Certification Fee Type

Amount

Application Fee:
Member Technique Fee (From box on Line 2 above):
Non-Member Technique Fee (From box on Line 3 above):

$150.00
$
$

Certification Fee Total (Total of Application and Technique Fees): $

5)

Go back to page 1 and place the Certification Fee Total above in the block titled "Certification Fees".

ACCP Level III

ACCP Level III certification fees are made up of three items: an Application fee, the Test Method fee and an International Surcharge.
The Application fee is a fixed fee that is charged once per application. The Test Method fee is based on the number of NDT Test
Methods selected and whether or not you are a current ASNT Member. The International Surcharge is applied to all non-US residents
to cover the additional cost of international mailings.
To determine your Certification Fees, do the following:
1) Count the number of Test Methods you applied for in the Certifications Requested table on page 1;
2)

If you are a current ASNT member, multiply that number by $95.00: _______Test Methods x $95.00 = $

3)

If you are NOT an ASNT member, multiply that number by $170.00:

_______Test Methods x $170.00 = $

NOTE: If you are not currently an ASNT Member, you can fill out the membership
application on pages 8 & 9, then take advantage of the ASNT Member pricing.
4)

Place the amount from the appropriate box above and place that amount in the table below as your Test Method Fees;

Certification Fee Type

5)

Amount

Application Fee:
Member Test Method Fee (From box on Line 2 above):
Non-Member Test Method Fee (From box on Line 3 above):

$210.00
$
$

Certification Fee Total (Total of Application and Test Method Fees):

Go back to page 1 and place the Certification Fee Total above in the block titled "Certification Fees".

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Document Submittals
The following documents* must be submitted with this application:
1) A copy of your currently valid JIS Z 2305 NDT certificate issued by JSNDI;
2) A valid (within 12 months) vision examination showing near visual acuity to Jaeger J-1 or equivalent; and
3) One (1) passport photograph.

Attach

Applicants must also provide a signature in the block below, which will be scanned
and transferred electronically onto their ACCP wallet card. The signature must stay
completely within the block with no overlap onto the block borders.

passport

Signature Block:

photo
here
* The essential information (name, Levels, test methods, Techniques, etc.) on all documents
must be in English. Hand-written translations are acceptable.

Pressure Equipment Sector Experience

ACCP certification in the Pressure Equipment (PE) Sector requires three (3) years of documented experience in pressurerelated inspection. Applicants wishing to certify in the Pressure Equipment Sector must fill out the form below and have it
signed by a JSNDI, ASNT NDT, ACCP Professional Level III or an Authorized Inspector.
Photocopy this page as necessary to document your experience. List positions in reverse chronological order.

Position #

Dates of Employment
Start Date

End Date

Total Time (Months)

Organization Name

Employer Contact Name

Organization Address
City

State/Prov.

ZIP/Postal Code

Phone

Fax

Email

Country

In the space below, provide a summary of the type of work performed during this engagement. Include the inspection
equipment used, the level of responsibility, and list specific inspection functions performed as described above.

I have reviewed this application and hereby attest that the experience times claimed by the above applicant are true and
correct to the best of my knowledge. I understand that should the above information be found fraudulent, the applicants
certification may be revoked and other penalties may apply.
Printed Name

Signature

Date

Position/Title

ASNT NDT, ACCP Professional Level III or JSNDI Level III Certification No.

or
Company

AI* Certificate No.

*A photocopy of the AIs currently valid certification card must be attached to this application when an AI signs off on the experience.

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Affirmation of the Applicable Code of Ethics for Personnel Certified by ASNT

By signature on this application, if certified by ASNT, I agree to abide by the applicable* Code of Ethics
for 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 II and/or
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 undersigneds
activities henceforth as Level II and/or 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. I have read and understand the attached transfer, cancellation and refund policy and
understand that all application documents submitted to ASNT become the property of ASNT.
I authorize ASNT to publish my name, city, state, country, test methods, Levels and expiration dates of
certification.

Print Name of Applicant

Signature of Applicant

Date

* The ACCP Level II and the ASNT Level III Codes of Ethics are shown on pages 6 & 7 respectively.

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Vision Requirements
Candidate Name (please print):

Eye Exam Date:

Vision examinations shall be administered by a physician, licensed nurse, ophthalmologist or optometrist, or by personnel
approved by the employers Level III. The visual examination date must be within 12 months of the date that this
application is signed. The form below may be used to document this requirement.

Near distance vision

Candidates must have visual acuity in at least one eye capable of reading the Jaeger J1 test chart, or equivalent, at the
distance specified on the chart for J-1 text, but no less than 30.5 cm (12in.)

Color vision
You must be able to differentiate between the colors used in the NDT method(s) for which certification is required.

Attestation of Visual Acuity

I attest that I have administered the following vision examinations to the candidate named above:
Near distance visual acuity in at least one eye capable of reading the Jaeger J1 test chart, or equivalent, at the
distance specified on the chart for J-1 text, but no less than 30.5 cm (12in.).
The candidate

passed
(check one)

did NOT pass

this examination

with
(check one)

without

correction.

I further attest that I administered a color perception examination on the candidate named above, and that the
candidate has:
No Color Perception Deficiency

Color Perception Deficiency (Specify):

Signature of Eye Examiner

Ophthalmologist/Optometrist
Employers Level III

Date

Physician

Registered Nurse

Certificate No:

Other (Approved by the Employers Level III):

Expiration Date:
Title:

Employer Attestation (for Candidate Color Perception Deficiency)

If the candidate has a color perception deficiency, the candidates ability to distinguish colors used in the applicable
method(s) as specified by the employer must be confirmed by the employer or a designated and responsible agent of the
employer (such as an ASNT Level III, ACCP Professional Level III, or company Level III per SNT-TC-1A).
I attest that the above named candidate has sufficiently demonstrated the ability to distinguish colors used in the
applicable test method(s) as specified in employer procedures.

Employer/Agent Signature

Date

Employer/Agent Name (print)

ASNT ID (if applicable)

Title

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Refund Policy
If a certification application is received and the applicant is found to be unqualified to be certified for the requested Level or Test
Method(s), a refund will be issued less an administrative fee of $75.00 PER METHOD.
The International Surcharge and Membership / Administrative Fees are non-refundable and non-transferable.
No exceptions will be made to the above policy.

Code of Ethics for ACCP Level II Personnel Certified by ASNT

1.0

Purpose
1.1 The following Code of Ethics is binding upon every individual who possesses a current ACCP
Level II Certification. These rules are necessary to protect the life, health, property and welfare of
the public, and to maintain the credibility of the ASNT Central Certification Program and the NDT
profession. Accordingly, each ACCP Level II certified individual agrees to:

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 in accordance with properly established and approved procedures and
only 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
tests conducted, procedures used, and results obtained.
2.3 Conflict of Interest: Consciously avoid conflict of interest situations with employer or client, promptly
informing same if such situations cannot be avoided.
2.4 Improper Conduct: Refrain from work activities outside the area of certification without written
approval of his/her supervisor.
2.5 Safety: Act in a safe and responsible manner while conducting NDT activities, ensuring that all
required and necessary safety procedures are in place and are being used by ones self and others
under his/her jurisdiction.

3.0

Penalty
Violation of this Code of Ethics by any ACCP certified Level II person may be cause for disciplinary
action against that person.

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Code of Ethics for Level III Personnel Certified by ASNT

1.

2.

3.

4.

Preamble
1.1. In order to safeguard the life, health, property, and welfare of
the public, to maintain integrity and high standards of skills
and practices in the profession of nondestructive testing, the
following rules of professional conduct shall be binding upon
every person issued a certificate by ASNT as a Level III.
1.1.1. The Level III who holds a certificate is charged with
having knowledge of the existence of the reasonable
rules and regulations hereinafter provided for his/her
conduct as ASNT Level III, and also shall be familiar
with their provisions and understand them. Such
knowledge shall encompass the understanding that
the practice of nondestructive testing under this
certification is a privilege, as opposed to a right, and
the Level III shall be forthright and candid in
statements or written responses to the Ethics
Committee of the Certification Management Board.
1.1.2. The Level III as referred to herein is that individual
who has been issued a certificate by the American
Society for Nondestructive Testing, Inc. pursuant to
its heretofore published requirements, rules, and
procedures for such certification. This Code of Ethics
is binding upon all individuals so certified.
Integrity
2.1. The Level III is obligated to act with complete integrity in
professional matters for each client or employer as a faithful
agent or trustee; shall be honest and impartial; and shall
serve the public, clients, and employer with devotion.
Responsibility to the Public
The Level III shall:
3.1. Protect the safety, health, and welfare of the public in the
performance of professional duties. Should the case arise
where the Level III faces a situation where the safety, health,
and welfare of the public 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; and
3.1.2. Refuse to accept responsibility for the design, report,
or statement involved; and
3.1.3. If necessary, sever relationship with the employer or
client; and
3.1.4. Undertake to perform assignments only when
qualified by training and experience in the specific
technical fields involved. In the event a question
arises as to the competence of an Level III to perform
an assignment in a field of specific discipline which
cannot be otherwise resolved to the Ethics
Committees 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 or on behalf of the Ethics
Committee; and
3.1.5. Be completely objective in any professional report,
statement, or testimony, avoiding any omission which
would, or reasonably could, lead to fallacious
inference, finding, or misrepresentation; and
3.1.6. Express an opinion as a technical witness before any
court, commission, or other tribunal, only when such
opinion is founded upon adequate knowledge of the
facts in issue, upon a background of technical
competence in the subject matter, and upon an
honest conviction of the accuracy or propriety of the
testimony.
Public Statements
4.1. The Level III will issue no statements, criticisms, or
arguments on nondestructive testing matters connected with
public policy which are inspired or paid for by an interested
party, or parties, unless he/she has prefaced the remark(s)
by explicitly identifying himself/herself, by disclosing the
identities of the party, on whose behalf he/she is speaking,
and by revealing the existence of any pecuniary interest
he/she may have in these matters.
4.2. The Level III will publicly express no opinion on a

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5.

6.

7.

8.

9.

nondestructive testing matter unless it is founded upon

adequate knowledge of the facts in issue, upon a
background of technical competence in the subject matter,
and upon honest conviction of the accuracy and propriety of
the testimony.
Conflict of Interest
5.1. The Level III shall conscientiously avoid conflict of interest
with the employer or client, but when unavoidable, shall
forthwith disclose the circumstances to the employer or
client.
5.2. The Level III shall promptly inform the client or employer of
any business associations, interests, or circumstances which
could influence his/her judgment or the quality of services to
the client or employer.
5.3. The Level III shall not accept compensation, financial or
otherwise, from more than one party for services on the
same project, or for services pertaining to the same project,
unless the circumstances are fully disclosed to, and agreed
to, by all interested parties or their duly authorized agents.
5.4. The Level III shall not solicit or accept financial or other
valuable consideration from material or equipment suppliers
for specifying their 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 client or employer in connection with work
for which he/she is responsible.
5.6. As an elected, retained, or employed public official, the Level
III (in the capacity as a public official) shall not review or
approve work that was performed by himself/herself, or
under his/her direction, on behalf of another employer or
client.
Solicitation of Employment
6.1. The Level III shall not pay, solicit, nor offer, directly or
indirectly, any bribe or commission for professional
employment with the exception of payment of the usual
commission for securing salaried positions through licensed
employment agencies.
6.2. The Level III shall seek professional employment on the
basis of qualification and competence for proper
accomplishment of work.
6.3. The Level III shall not falsify or permit misrepresentation of
his/her, or his/her associates, academic or professional
qualification. He/she shall not misrepresent or exaggerate
the degree of responsibility in or for the subject matter of
prior assignments.
6.4. Brochures or other presentations incident to the solicitation
of employment shall not misrepresent pertinent facts
concerning employers, employees, associates, joint
ventures, or past accomplishments with the intent and
purpose of enhancing qualifications and work.
Improper Conduct
7.1. The Level III shall not sign documents for work for which
he/she does not have personal professional knowledge and
direct technical supervisory 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 or firm which he/she knows, or has reason to
believe is engaging in business or professional practices of a
fraudulent or dishonest nature.
Unauthorized Practice
8.1. Any violation of this code shall be deemed to be an
unauthorized practice and upon proper complaint,
investigation, due process hearing and ruling of the Ethics
Committee of the ASNT Certification Management Council in
accordance with procedures heretofore established and
published, sanctions may be applied to the individual(s) in
violation.
Rulings of Other Jurisdictions
Conviction of a felony while ASNT certification is valid or the
revocation or suspension of a Professional Engineers License by
another jurisdiction or similar rulings by other professional
associations may be grounds for a charge of violation of this
Code.

7/7/09

ASNT Individual Membership Application & Renewal Form

Member Information
Last Name

First Name

Send Membership Materials to:

Home

M.I.

Office

Join now for immediate and significant savings on

examination fees. Save $75 per method.

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.

Become part of the foremost nondestructive testing

society and be fully connected to the NDT world.

ASNT membership includes:

25% discount on all items purchased from our
Publications Catalog or Shop ASNT online at www.asnt.org

Membership Options

New Member Dues

Renewal Member Dues

To qualify to pay as a renewing member, your membership expiration date must
be within six months.

Dues

Renewal Member
Two-Year
Three-Year
Five-Year
Student, One-Year
Must submit transcript or letter or enrollment

Military Rank E-5 or lower

No

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 www.asnt.org provides publications
and networking functions
Serve on ASNT committees; be part of a group that may effect
change or the industry

Earn recertification points for ASNT membership.

One-Year

Yes

Former Member:

Phone

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

*Dues with Airmail

*New Member

*Dues with Airmail

Service included

Dues

Service included

$65
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$113
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$465
$63
$78

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$135
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Dues include subscriptions to

Materials Evaluation and
The NDT Technician.
For members outside
North America: Unless
airmail is specified, all materials will
will be sent sea/surface mail;
allow 3-4 months for delivery.
*Airmail service is restricted
by availability or cost; airmail
may not be offered to your
country. You will be contacted
if service cannot be provided.

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

With Airmail
Service Included

RNDE is ASNTs quarterly research journal.

$55
$55
$75

Print Subscription - for current volume

Electronic Subscription - for current volume
Print and Electronic Subscription - a savings of $35

$129

Add a subscription to
ASNTs quarterly research
journal, RNDE.

$149

All 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 Profile
1. Year of Birth
2. Gender

9. Choose the one business segment that best

describes your company. (select only one)
Male

Female
NDT Utilization Business

3. Highest Education Level

Grades 1 - 12
High School Diploma
Some College
2-Year Associate Degree
4-Year Undergraduate Degree
Master's Degree
Doctorate Degree
4. Years of Experience in NDT

1-5 6-10 11-15 16-20 21 & over

5. Number of people involved with NDT at
your company

1-5 6-20 21-50 51-100 over 100

Aerospace/Aviation/Aircraft
Amusement Rides & Skiing
Automotive
Chemical & Petroleum
Construction
Commercial Labs
Infrastructure (Roads & Bridges)
Electronics
Marine
NDT Supplier Business
Consulting
Distributor/Manufacturer's
Representative
Equipment
Research

Medical
Nuclear
Optical
Ordnance
Pipeline
Pulp/Paper
Railroad
Semiconductor
Utilities

Robotics
Supplies
Training
Computer Software
Computer Hardware

6. Your Job Function - Choose the one that

10. Choose the primary type of NDT that you do.
best describes your role. (select only one)
(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 III
Training & Study Materials/Programs
Level I
ACCP Level II
Services
Level II
ACCP Level III
I am not involved in purchasing
Level III
IRRSP
8. With which NDT method(s) do you work?
(select all that apply)
Acoustic Emission
Alternating Current Field Measurement
Electromagnetic/Eddy Current
Ground Penetrating Radar
Infrared & Thermal
Laser
Leak
Liquid Penetrant

Magnetic Flux Leakage

Magnetic Particle
Neutron Radiography
Radiography
Ultrasonics
Vibration Analysis
Visual

For Questions Contact the Membership Department at:

Phone 614.274.6003
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Toll Free 800.222.2768 (US/Canada)

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