API - 570 Application
API - 570 Application
When you have completed your application package please use the following checklist to ensure you have included all of the following: Checklist
1. All pages of the application filled out completely. Applications must be ORIGINAL. We will not process faxed or scanned applications. 2. If you have previously applied to API and been assigned a 5-digit ID number, please include it every place that your name appears.
3. The certification fee. See pages 2 and 3 for other IMPORTANT PAYMENT INFORMATION. We will not process an application until full payment is received.
4. A notarized Employment Reference Form. The required documented length of your experience has to do with your level of education. If you changed employers in the last three years, you may make copies of this form and submit a separate notarized form from each employer. If there is not a notary available in your country you must use the alternative method of confirming your employment. (See Page 8 for further instructions.) 5. A photocopy of your diploma (in English) or a copy of your school transcripts (if you have less than five years of relevant experience). 6. Signed Inspector Agreement Forms. PLEASE KEEP A COPY OF YOUR APPLICATION FOR YOUR RECORDS.
API
Individual Certification Programs 1220 L Street, NW Washington DC 20005 Phone: 202-682-8064
Please include candidate name(s) on all payments. s
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Payment Policy 1. API cannot process any application until full payment is received. Proof of full payment must be included with your application. 2. Applicants WILL NOT BE PERMITTED TO TAKE AN EXAMINATION unless full payment has been received and processed by API. 3. Each applicant is responsible for making the timely payment for their examination or rescheduling fees. If your company is making the payment for you, please inform them of this policy. 4. No exceptions will be made under any circumstances. Refund Policy 1. All requests for refunds must be submitted to API in writing by mail, e-mail or fax. 2. ALL REFUND REQUESTS MUST BE MADE WITHIN 6 MONTHS FROM THE DATE OF THE PAYMENT. FOR REFUND REQUESTS made before the application deadline: API will refund the initial certification fee less $100.00 for processing. FOR REFUND REQUESTS made after the application deadline: API will refund 50% of the initial certification fee. Reschedule fees are non-refundable. FOR REFUND REQUESTS made after the date of your examination: NO REFUNDS WILL BE ISSUED IF YOU TOOK THE EXAMINATION NO REFUNDS WILL BE ISSUED IN CASE OF A NO-SHOW
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Program
653, TES, 571, 577, 580
Application Deadline
January 14, 2011
June 1, 2011
July 8, 2011
December 7, 2011
API cannot process any application until full payment is received. Proof of payment must be included with your application. Application deadlines are no longer postmark deadlines. API must RECEIVE your application on or before the application deadline. We must have original documents; we will not process faxed or scanned applications.
Candidates will not be allowed to take the examination if payment has not been received and processed by API.
All payments must be made in United States currency. Paying by credit card provides the best opportunity to ensure that payment is received and processed by API, thus securing your place in the examination. CHECKS MUST BE DRAWN FROM A U.S. BANK. You are responsible for all taxes, banking or other service fees, including all applicable withholding taxes. If your company is going to pay the fee make sure they know the deadline and allow plenty of time for the company to make payment.
If paying by wire transfer please submit a copy of the transaction document with your application. If the copy is not included with the application please e-mail a copy to inspector@api.org as soon as possible to allow time to identify the payment and credit your application.
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Application Form
API 570, Piping Inspector Certification Program New Certification EXAM ID # _____________________
(if previously assigned)
Middle Name
Country
Employer Data
Employer
Fax Number
Country
Please indicate at which address you wish to receive API-related materials. Are you interested in being included in the API Inspector Directory, when you obtain your certification? Please indicate which address you wish to have included in ICP Directory listing.
Work No Work
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Supplemental Information
API 570, Piping Inspector Certification Program
1. Do you currently have an active API certification? If yes, enter your certification number and expiration date. If you answer yes, you need not complete the Education and Training Form. Yes No
Are you currently a full-time, non-contract employee of an API member company? If yes, please enter the company name.
3.
Please check the boxes that correctly describe your organization. Please be sure to check one box on each side. Industry Organization type
Please check the boxes that correctly describe your employment status. Please be sure to check one box only.
Full-time employee of an owner/user Full-time employee of an inspection agency/other company Independent contractor
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Name
Location
Year Graduated
Name
Duration of Studies
Field of Study
Year Graduated
Name
Duration of Studies
Field of Study
Year Graduated
Name
Duration of Studies
Field of Study
Year Graduated
College
Name Duration of Studies Major Degree Type Dates Attended
Name
Duration of Studies
Major
Degree Type
Dates Attended
Name
Duration of Studies
Major
Degree Type
Dates Attended
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1.
Name and Address of Employer (Current) Employer Mailing Address (Number and Street) City, State and Zip Code Job Title / Description of Responsibilities
2.
Name and Address of Employer Employer Mailing Address (Number and Street) City, State and Zip Code Job Title / Description of Responsibilities
3.
Name and Address of Employer Employer Mailing Address (Number and Street) City, State and Zip Code Job Title / Description of Responsibilities
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All paperwork documenting the applicant work experience MUST be original s documents. Photocopied, scanned, or faxed documents will not be processed. API requires that the supervisor signature be notarized on all ERFs. s However, in countries where notaries are not available (see the partial list below), API allows for an alternative method of the experience verification. If a notary is not available in your country then ALL THREE OF THE FOLLOWING MUST BE DONE to complete the documentation of your employment: 1. The ERF must be signed by a supervisor. 2. The ERF must be stamped with a company stamp instead of the notary stamp employment confirmation 3. In addition to the ERF the applicant must provide an letter This letter must be submitted on company letterhead, and signed by a . company official higher than the applicant supervisor (such as department s manager, director, vice-president). The letter must confirm that the applicant is employed in an inspector capacity and include a description of the job responsibilities. Some countries where this method may be used: Australia Belgium France Indonesia Kuwait New Zealand Portugal Sweden Canada Brunei Greece Ireland Malaysia Norway Qatar Thailand Bahrain Denmark India Italy Netherlands Oman Saudi Arabia United Kingdom
For Canadian applicants, a Commissioner of Oaths may sign the ERF in lieu of the notary, but API requires the proof of the Commissioner license. s
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Beginning Date
Ending Date
SUPERVISORS: Please fill in the blanks below. Your notarized signature on this page validates that during the period indicated above the applicant has acquired the following experience. THE BOX BELOW MUST BE COMPLETED. PLEASE CIRCLE THE APPLICABLE ACTIVITIES. Activity
Design
How much time was spent in inspection? (At least one year required)
Yrs _____ Mos ______
ALL APPLICANTS MUST HAVE THE AREA BELOW COMPLETED AND NOTARIZED (If notary is not available see Page 8 for alternative verification requirements.) SUPERVISOR NAME (PLEASE PRINT) __________________________________ S
__________________________________________ _______________________
Supervisor's Signature Date Subscribed and sworn to before me the ___________________ day of ________________, ______.
Date
FOR SEPTEMBER 23, 2011 EXAM -- USE FORM ON PAGE 11 Attention: A sitting fee will be required at this location.*
(This fee is charged by the local jurisdiction and is due at the exam site on the day of the exam. The fee varies by site but is generally less than $100.00 and will be made payable to the appropriate state office.) You will receive
information from API prior to the exam date with payment instructions.
North America:
Alaska: Anchorage * Alberta: Edmonton (Canada) * California: Oakland California: Los Angeles Georgia: Atlanta Louisiana: Baton Rouge *Minnesota: St. Paul *Oklahoma: Oklahoma City Pennsylvania: Philadelphia Texas: Corpus Christi Texas: Houston
Other Locations:
Colombia, S.A. Kuwait Singapore Egypt: Cairo Malaysia Trinidad India: Chennai Qatar UAE: Abu Dhabi India: Mumbai Saudi Arabia: Al-Khobar United Kingdom
ATTN: To organize a test site at a location not listed above please see details at www.api.org/icp (General Information; Special Sites). Contact API well in advance of deadlines to allow time to set up the site.
> > THIS FORM MAY ALSO BE USED TO RESCHEDULE A TEST <<
PLEASE INCLUDE PAYMENT OF THE APPROPRIATE FEE SEE PAGES 2 AND 3 FOR IMPORTANT PAYMENT POLICY SEE PAGE 16 for payment remittance instructions.
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Please indicate your preferred testing location. Every effort will be made to assign you to the location of your choice.
North America:
Alaska: Anchorage Alberta: Edmonton (Canada) California: Los Angeles California: Oakland Georgia: Atlanta Louisiana: Baton Rouge Minnesota: St. Paul Oklahoma: Oklahoma City Pennsylvania: Philadelphia Texas: Corpus Christi Texas: Houston
Other Locations:
Colombia, S.A. Kuwait Singapore Egypt: Cairo Malaysia Trinidad India: Chennai Qatar UAE: Abu Dhabi India: Mumbai Saudi Arabia: Al-Khobar United Kingdom
ATTN: To organize a test site at a location not listed above please see details at www.api.org/icp (General Information; Special Sites). Contact API well in advance of deadlines to allow time to set up the site.
>> THIS FORM MAY ALSO BE USED TO RESCHEDULE A TEST << PLEASE INCLUDE PAYMENT OF THE APPROPRIATE FEE SEE PAGES 2 AND 3 FOR IMPORTANT PAYMENT POLICY SEE PAGE 16 for payment remittance instructions.
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by this Agreement, or upon expiration/termination of the Inspector certification, Inspector agrees to s return all certification documents to API within 30 days. 9. The Inspector shall not use any trademark of API or name of API including any abbreviation thereof, in any publicity, advertising, or for other promotional purposes without the prior written approval of API. 10. The Inspector agrees to comply strictly with all U.S. export laws relating to this program. The Inspector warrants that he is not located in, or under the control of, or a national or resident of any embargoed countries. 11. This agreement shall not and is not intended to benefit or to grant any right or remedy to any person or entity that is not a party to this Agreement. 12. This instrument contains the entire and only agreement between the parties. representations not herein contained shall have any force and effect. 13. Paragraphs 2, 3, 4, 5, 6, 7, and 8 survive termination of this agreement. 14. It is expressly understood between the parties hereto that no association, agency, apparent agency, employer/employee relationship, partnership, or joint venture of any kind has been created. Inspector agrees not to refer to himself as API agent nor refer to the relationship between the parties as a joint venture or s partnership or any in manner inconsistent with this Agreement. Inspector shall have no authority to act or contract on behalf of API. 15. No waiver API of any default, misrepresentation, or breach of warranty or covenant hereunder, regardless of whether intentional, shall be deemed to extend to any prior or subsequent default, misrepresentation, or breach of warranty or covenant hereunder or affect in any way any rights arising by virtue of any prior or subsequent such occurrence. 16. API makes no express or implied warranties regarding the ICP program or potential benefits of the certification to the Inspector. 17. The Inspector agrees to pay all sales, use, property, excise, and other taxes now or hereafter imposed by any government body or authority based on in any way measured by this Agreement, or any portion or it, or any services related thereto. 18. Inspector understands and agrees that Inspector is not granted any rights under the program or this Agreement until API has determined that the Inspector has satisfied all of the program requirements and has issued a Certificate to the Inspector. The Inspector certification shall be effective on the date that is noted on the s Certificate and shall be effective for a period of three years unless terminated pursuant to the terms of this Agreement. 19. This Agreement shall be governed by and construed in accordance with the laws of the District of Columbia, USA, without regard to the rules regarding conflicts of law. The parties agree that any action, suit, or proceeding based upon any matter, claim, or controversy arising hereunder or relating hereto shall be brought exclusively in the federal or state courts located in District of Columbia, USA. The parties consent to the jurisdiction and venue of such courts, and waive any objections to the jurisdiction and venue thereof. No oral statements or
I, the undersigned, certify that I have read and fully comprehend this form in its entirety and agree to comply with the conditions specified above. Applicant name (please print) ________________________ s E-mail: ______________________
_________________ Date
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significant changes to the program by either giving notice: (1) at the Applicant last known address, or (2) the s Applicant last known e-mail address, or (3) by posting the changes on the API website. It is the s responsibility of the Applicant to notify API of address changes. The failure of API to notify Applicant of a renewal date or modification of the program does not relieve the Applicant of the responsibility to file a timely renewal application or to comply with new certification requirements. It is the responsibility of the Applicant to obtain this information by contacting API or by checking the API website. 14. The Applicant agrees to comply strictly with all U.S. export laws relating to this program. The Applicant warrants that he is not located in, or under the control of, or a national or resident of any embargoed countries. 15. The Applicant agrees to pay all sales, use, property, excise, and other taxes now or hereafter imposed by any government body or authority based on in any way measured by this Agreement, or any portion or it, or any services related thereto. 16. Applicant warrants and represents to all information that is being submitted pursuant to this is complete and accurate. Applicant understands that API is relying upon the accuracy of this information in evaluating the Inspector qualifications. Applicant agrees to indemnify API for any claims, losses, or damages resulting s from the Applicant submitting inaccurate or misleading information.
I, the undersigned, certify that I have read and fully comprehend this form in its entirety and agree to abide by the policies and regulations specified above.
E-mail: ______________________
_________________ Date
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API Member
$600.00
Non Member
$800.00
PAYMENT INSTRUCTIONS All payments must be made in United States currency. CHECKS MUST BE DRAWN FROM A U.S. BANK. You are responsible for all taxes, banking or other service fees, including all applicable withholding taxes. For payments by electronic transfer: (1) you are responsible for all electronic transfer, A.C.H. and banking fees (be sure to add the fees to your payment; (2) for electronic payments not drawn on a U.S. bank a fifty-dollar ($50) handling fee must be added at the time payment is made. Please include a copy of the transaction documentation when possible. PAYING BY CREDIT CARD CAN EXPEDITE THE PROCESSING OF YOUR APPLICATION AND PAYMENT TO ENSURE YOUR PLACE IN THE EXAMINATION.
Credit Card Type: Card Number: Visa American Express Expiration Date: _____________________________________________
Initial Certification Fee Reschedule / Retest Fee
MasterCard
_______________________________________
($150.00)
Penalties / Other Bank Fee (if wired)
TOTAL SUBMITTED
(Reference: Applicant Name and SS-2100-D9200-7110) s For wire transfers please make sure to add pertinent bank fees to your payment. Please include a copy of the transaction documentation or forward copy as soon as transaction is completed.
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ii. B31.3, Process Piping, 2008 Edition IHS Product Code for the ASME package API CERT 570 ASME. Package includes only the above excerpts necessary for the exam.
API and ASME publications may be ordered through IHS Documents at 303-397-7956 or 800-854-7179. Product codes are listed above. More information is available at http://www.ihs.com. API members are eligible for a 30% discount on all API documents; exam candidates are eligible for a 20% discount on all API documents. When calling to order, please identify yourself as an exam candidate and/or API member. Prices quoted will reflect the applicable discounts. No discounts will be made for ASME documents. Note: API and ASME publications are copyrighted material. Photocopies of API and ASME publications are not permitted. CD-ROM versions of the API documents are issued quarterly by Information Handling Services and are allowed. Be sure to check your CD-ROM against the editions noted on this sheet. 570 01/2011
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