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1, Batam 29457, Indonesia Tel/Fax: +62-778-495120, +62-778-495121 REGISTRATION AND TERM & CONDITION PLEASE USE CAPITAL LETTERS
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Candidates should pay Registration Fee USD 85.00 for 3.0 & USD 165.00 for 3.1, 3.2, CSWIP, BGAS, PCN, IOSH, NEBOSH Courses. Any cancellation less than 1 week before commencement of course shall be charge 100% of Registration Fee*. Make sure that name should be the same with your passport or ID Card, any request to change the name on your Certificate & ID Card shall be charge USD 25.00 per method. In order to send certificates shall be charge USD 15.00 (ASEAN Country) & USD 35.00 for outside ASEAN. Cancellation of Exam / Retest less than 1 week before commencement of exam shall be charge 20% from total Exam / Retest Fee. Total Payment shall be settled 1 week before commencement of course*. Payment Method by Cash or Transfer. We dont accept Credit Card & Debit Card for the time being.
Our Account
Account Name : PT. DUA UTAMA JAYA Bank : - Bank Mandiri, Batam Branch Jl. Imam Bonjol No. 1, Nagoya, Batam 29457, Indonesia IDR Account No : 109-000426703-5 USD Account No : 109-000-464618-8 Swift Code : BEIIIDJA Our services are strictly limited to the training purposes, this training will include lunch (dinner), 2 times coffee break & training materials. Any other services not specified in this list shall be supplied by participants. Details of Registration and this Term and Condition is exclusively for PT Dua Utama Jaya only. Should you need more details, please do not hesitate to contact us at: enquiry@ptduj.com or call us at : +62778495120, +627787239020.
Candidate Confirmation
(.) Name: .
Date: .
TWI Training & Certification (S.E.Asia) Sdn Bhd No. 8, Jalan TSB 10 Sg. Buloh Industrial Park 47000 Sg. Buloh, Selangor, Malaysia Tel.: +603-61573528 / 7 /6 Fax. +603-61572378 E-mail: inquiry@twisea.com
PLEASE USE CAPITAL LETTERS THROUGHOUT
WIM/WJS/TWI Industrial MEMBERS ONLY: To claim your discount (course fee only) please enters your Membership No: WIM Membership No. : ..
METHODS OF PAYMENT
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 BACS made payable to : TWI Training & Certification (S.E.Asia) Sdn. Bhd. OR Credit Card (Please Indicate if Company Card) YES NO
Three digit security code _____________________________________________ Valid from & Expiry date ____________________________________________ Issue Number _____________________________________________________ Name (as it appears on card) _________________________________________________________________ House number and postcode of card holder: _________________________________________________________________ Signature of card holder _____________________________________________ OR Company order no __________________________________________ Approving Managers name __________________________________________
Title _______________________________________________
SPONSORS SIGNATURE:
Date: __________________________________________________
Miri
Others: (please specify) Batam - Indonesia Where did you hear about TWI Ltd?
TWI Training website Bulletin / Connect BINDT Publications TWI Training newsletter NDT Cabin Other
PT
RT Dig Rad
ET PAUT
RI
UT
VT
BRS ACFM
AUT
TOFD
Level 2
Level 3.2.1
Instructor ASCAN
3.1U
3.2U
To be completed by all applicants applying to attend CSWIP Welding Inspection Examinations I confirm that I have read and comply with the pre examination entry requirements as laid down in the CSWIP Requirement Documents DOCUMENT No. CSWIP-WI-6-92, 10th Edition January 2011 and understand that any fraudulent claim may result in the retraction of any certifications issued. Please tick the appropriate box and give a detailed statement of how you meet the requirements, this must be signed and verified by an employer/third party Visual Welding Inspector (Level 1) 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.
Welding Inspector (Level 2) Welding Inspector for a minimum of 3 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 1) for a minimum of 2 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 of 5 years.
Senior Welding Inspector (Level 3) Certified Welding Inspector (Level 2) for a minimum of 2 years with job responsibilities in the areas listed in 1.2.1, 1.2.2 and 1.2.3. 5 years' authenticated experience related to the duties and responsibilities listed in Clause 1.2.3, independently verified.
Welding QC Co-ordinator A current valid CSWIP 3.2 Senior Welding Inspector certification plus three years documented experience related to the duties and responsibilities or an international equivalent. A current valid CSWIP 3.1 Welding Inspector with 10 years documented experience related to the duties and responsibilities or an international equivalent.
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 NDT 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
Name (in capitals): __________________________________________ Company: Position: Telephone no.: Email Address: Date: __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ Authenticated Company Stamp
To be completed by all applicants applying to attend CSWIP Plant Inspection Examinations I confirm that I have read and comply with the pre examination entry requirements as laid down in Section 3 of the CSWIP Requirements Documents DOCUMENT No. CSWIP-11-01 and understand that any fraudulent claim may result in the retraction of any certification issued. Please tick the appropriate box and give a detailed statement of how you meet requirements, this must be signed and verified by an employer/third party Plant Inspection (Level 1) I hold current approved NDT Level 2 (ACCP, CSWIP, or PCN) in two methods (BGAS Painting Inspector and CSWIP 3.1 Welding Inspection qualifications are acceptable as methods) I hold CSWIP 3.1 Welding Inspector or higher I hold ONC in Mechanical Engineering or equivalent
I have a minimum of Five years, assessed and authenticated industry experience in this field (Mature Entry Route), a verified CV can be supplied Must be authenticated by Line Manager
_______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________
Plant Inspections (Level 2) I I hold a valid Level 1 Plant Inspection approval I have successfully completed the level 1 exams as a pre entry requirement
_______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________
To the best of my belief, the candidates statement given above is correct at the time of signing.
Verifying signature (employer 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 scheme management that is relevant to the 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 the 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.
CANDIDATES SIGNATURE:
INSTRUCTIONS In order to facilitate the course/examination form, please ensure that the forms are completely read, understood the requirement & dully fill in the forms. Step 1 Please be reminded that the page 1 (front page) requires, name in full as per passport, DOB & both addresses (one permanent address & the other is the correspondence address) in capital letters, if sponsored by the company than also put in the company names & full address in capital letter. On the method of payment, please sign at the bottom to indicate that you or the company is responsible for the payment. Step 2 Page 2 requires you to indicate what scheme (PCN, CSWIP OR ACCP, etc) method of exams you are taking & level (Lev 1, 2, 3) of examination you require, as you scroll thru the same page below are the experience required by ticking the relevant boxes: Example; If you are taking Lev 2 (Welding Inspector), PLEASE INDICATE THE TICK BOX IN WHICH PART YOU BELONG TO OR WHICH PART TELLS YOU THE EXPERIENCE LEVEL THAT YOU HAVE, and also add in some information on the duties that you do briefly only, no need to be specific. Step 3 The final & most crucial part of this form is to get the VERIFICATION SIGNATURE FROM YOUR COMPANY IF SPONSORED BY THE COMPANY, IF SELF-SPONSORED THAN YOU REQUIRE TO GET A THIRD PARTY TO SIGN AT THE BOX JUST BELOW THE NDT PRE-CERTIFICATION EXPERIENCE. Please fill in the company name with the company stamp on the right box where it says Authenticated Company Stamp Final part is that you (candidate) need to read the statement below, understand them & please sign them at the bottom box indicated below the form. ---------------------------------------------------------------------------------------------------------------------------------------------------------------------PETUNJUK PENGISIAN FORMULIR Untuk memfasilitasi pengisian formulir ini, mohon pastikan Anda sudah membaca formulir ini secara menyeluruh, memahami persyaratan dan mengisinya dengan lengkap. Langkah 1 Di halaman 1, hal-hal yang perlu diisi adalah : nama lengkap sesuai paspor, tanggal lahir & alamat (alamat permanen & alamat korespondensi), nama & alamat perusahaan serta contact persons yang bertanggung jawab (bila disponsori oleh perusahaan) mohon ditulis dengan huruf capital/besar. Pada metode pembayaran, silakan tandatangan di bagian bawah untuk menunjukkan bahwa Anda atau perusahaan bertanggung jawab untuk pembayaran. Langkah 2 Di halaman 2, mengharuskan Anda untuk menuliskan jenis sertifikasi (PCN, CSWIP atau BGAS), metode ujian yang Anda ikuti (initial, retest, renewal, etc), tingkat/level ujian (1, 2, 3) serta sektor industri dimana Anda bekerja (aerospace, welds, wrought, etc). Kemudian pada bagian bawah, centang dan tuliskan pengalaman kerja secara singkat pada kotak yang relevan dengan Anda. Contoh; Jika Anda mengambil Level 2 (Welding Inspector), silahkan centang pada kotak yang sesuai dengan pengalaman kerja Anda. Kemudian tambahkan beberapa informasi tentang tugas-tugas yang Anda lakukan secara singkat, tidak harus spesifik. Langkah 3 Langkah yang paling penting dari formulir ini adalah untuk mendapatkan tandatangan dan verifikasi dari perusahaan yang mensponsori Anda. Bila Anda self-sponsored, maka Anda memerlukan tandatangan pihak ketiga (atasan, supervisor, rekan kerja). Silahkan bubuhkan tandatangan tersebut pada kotak di bawah bagian NDT Pre-certification experiences, sertakan juga nama lengkap penandatangan (perusahaan/pihak ketiga), nama perusahaan, jabatan, nomor telpon /email dan tanggal penandatanganan, serta cap perusahaan (pada kotak Authenticated Company Stamp). Terakhir, silahkan Anda membaca dan memahami penyataan di bagian bawah formulir dan bubuhkan tandatangan Anda pada kotak paling bawah.
CSWIP
EYESIGHT TEST
Some CSWIP certificates are only valid provided the holders eyesight is regularly tested and shown to meet the published minimum requirements.
Name :
Sheet No :
Date : Near Distance Test : Colour Vision Test : Name of qualified oculist or optometrist : Address :
Signature :
Date : Near Distance Test : Colour Vision Test : Name of qualified oculist or optometrist : Address :
Signature :
SEM/CSWIP/S511F/10.04
YEAR 2011
NETT P R I C E ( USD )
07 - 09 14 - 16 25 - 27 07 - 11 21 - 25
06 - 08 18 - 20 08 - 10 02 - 06 20 - 24 25 - 29
10 - 12 21 - 23 19 - 21 05 - 09 17 - 21 21 - 25 19 - 23
3.2.1 without RI
516
1,719
516
294
3.2.2 with RI
602
1,805
602
Interpreter Only
172
4 5 6
Welding QC Co-ordinator Bridging AWS to CSWIP NDT Appreciation Plant Insp Level 1 - Week 1
TBA 17 - 19 05 - 07 17 - 21
2,063 688 1,375 1,375 1,610 1,713 1367+ 80 PCN Levy 1,256
258 273 -
2,300 559 1,117 1,168 597 597 488 + 80 PCN Levy Radiographic Interpreter 3.4 7 days 03 - 11 11 - 19 04 - 12 14 - 22 1,031 364 364 708 + 80 PCN Levy 559 597 597 488 + 80 PCN Levy
294 Per Week ( All Grade ) 268 268 358 + 80 PCN Levy 175 -
8 9
10 CSWIP
( 1 & 2 category) 708 + 80 PCN Levy 1,762 + 80 PCN Levy PCN ( 3 & 4 categories) 11 CSWIP 619 ( 3 & 4 categories) PCN 12 CSWIP PCN 13 CSWIP PCN 14 CSWIP PCN 15 CSWIP PCN 16 CSWIP PRE-REQUISITE DOCUMENT FOR BOOKING CANDIDATES A. COURSE AND INITIAL EXAM 1. CV (Personal CV+TWI Enrollment Form) 2. Photograph size: 4x6 (3 pcs) CSWIP 3.0 (blue background) CSWIP 3.1 (red background) CSWIP 3.2 (yellow background) 3. PCN and BGAS (blue background) 4. Eye Test Report (Jaeger 1 + Ishihara) 5. Fill in Course & Exam Form 6. Administration / Booking = 20% x Course / Exam Fees
Pre-reuisite for Candidate who will attend TWI - CSWIP Course & Examination
492 for 1 or 2 Catgr + 80 PCN Levy 278 per Catgr + 80 PCN Levy 553 for 3 or 4 Catgr + 80 PCN Levy 368 for 1 or 2 catgr. 172 per Catgr. 454 for 3 or 4 Catgr. 373 + 80 PCN Levy 120 392 + 80 PCN Levy 199 392 + 80 PCN Levy 199 413 + 80 PCN Levy 313 413 + 80 PCN Levy 313 ( Retest ( Retest 493 + 80 PCN Levy 392 + 80 PCN Levy 189 ) ( Initial 189 ) 392 + 80 PCN Levy 189 ) ( Initial 189 )
777 + 80 PCN Levy 550 ( 1 & 2 category) 619 533 + 80 PCN Levy 258 512 + 80 PCN Levy 361 512 + 80 PCN Levy 361 722 + 80 PCN Levy 625 722 + 80 PCN Levy 625
10 days
14 - 25
28 - 9
533 + 80 PCN Levy 1,265 + 80 PCN Levy Ultrasonic Testing Lvl II ( TM ) 5 days 14 - 18 28 - 02 732 258 512 + 80 PCN Levy Magnetic Testing Level II 5 days 18 - 21 19 - 22 825 361 512 + 80 PCN Levy Penetrant Testing Level II 5 days 11 - 14 19 - 22 825 361 1,009 1,009 1,167 + 80 PCN Levy 891 1,167 + 80 PCN Levy
722 + 80 PCN Levy 4,332 + 80 PCN Levy Phase Array Level II 15 days 14 - 02 3,710 625 4,228
722 + 80 PCN Levy 4,056 + 80 PCN Levy TOFD Level II 10 days 05 - 16 3,498 625 3,953
B. RETEST ONLY 1. Copy of Results Notice Paper 2. Copy of Exam Report (For CSWIP-BGAS Painting Inspector) 3. Fill in TWI Exam Form (PCN Form: PSL 57 B, PSL 30, PSL 44) 4. Photograph size: 4 x 6 (3 pcs) CSWIP 3.0 (blue background) CSWIP 3.1 (red background) CSWIP 3.2 (yellow background) 5. Eye Test Report (Jaeger 1 + Ishihara) 6. Administration / Booking = 20% x Course / Exam Fees
C. INITIAL RETEST ONLY 1. Copy of Results Notice Paper and refresher attendance cert 2. CV (Personal CV+TWI Anrollment Form) 3. Photograph size: 4x6 (3 pcs) CSWIP 3.0 (blue background) CSWIP 3.1 (red background) CSWIP 3.2 (yellow background) 4. Eye Test Report (Jaeger 1 + Ishihara) 5. Fill in Course & Exam Form (if PCN Form: PSL 57A, PSL 30, PSL 44) 6. Administration / Booking = 20% x Course / Exam Fees
D. RENEWAL(5 YEARS) / RE-CERTIFICATION (10 YEARS) 1. CV 2. Original Certificate + ID Card 3. Fill in TWI Exam Form (PCN Form: PSL 57 B) 4. Photograph size: 4 x 6 (3 pcs) CSWIP 3.0 (blue background) CSWIP 3.1 (red background) CSWIP 3.2 (yellow background) 5. CSWIP WI Log Book (Track Record of Experiences 4 Year) 6. Administration / Booking = 20% x Course / Exam Fees
Should held minimum experiences in welding field Inspection as below: CSWIP 3.0: Above 6 Month QC Inspector or Candidates are expected to have an engineering background CSWIP 3.1: Above 3 Years as QC Inspector or 2 Years that have Cert. CSWIP 3.0 or 5 Years as Welding Instructor / Welding Forman CSWIP 3.2: Above 2 Years as QC Inspector + Held Cert. CSWIP 3.1 (Mandatory) + CSWIP RI 3.4 (PCN Lvl II) If Any NDT Appreciation: Welders / Fitters, Foreman, Supervisor and Manager Level Plant Inspector: Above 5 Years and held Multi Certificates of Discipline Inspection Painting inspector: Above 6 Month + QC Inspector, Engineer Background Site coating Inspector: Above 6 Month + QC Paint or Coating, Engineer Background
NDT - CSWIP/PCN Level II Personel Certification
Note: If there is any cancellation by candidate, less than 1 (one) week from the date of schedule, will be charged 20% from the total course fee / exam fee