Application Form for CSWIP 5 Year Renewal (Overseas) No Logbook

Application Form for CSWIP Five Year Renewal (Overseas) 1. CERTIFICATE HOLDERS DETAILS Nam DILEEP KUMAR PEMMADI e House/Building name or D.No:16-33-67/3,1ST STREET number Street/Road SAMBAMURTHY NAGAR ,KAKINADA name Town/Ci E.G.DIST ,ANDHRA PRADESH ty Postal/Zip 533001 code Count INDIA ry CSWIP certificate 55962 number Contact [email protected] email Contact telephone 00966552623781 number Date of Birth 21-NOV-1985 2. PAYMENT DETAILS The Fee for processing this Renewal Application is £109.50 (Pounds Sterling) Please note that all renewed Certificates are sent standard airmail with no tracking details. If you would like your renewed Certificate to be couriered with tracking details, there is an extra cost of £50.00 Please tick if you would like your renewed certificates couriered

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(Please

Note: We will not be able to courier to addresses with P.O. Box numbers) Payment can be made either by Cheque/Demand Draft made payable to TWI Certification Ltd or by Credit/Debit Card - give details below. IMPORTANT: If you are sending this application for review by email before posting the original, for the security of your card please do not send any card details by email. We thank you for your Co-operation with this. Card Holders Name Card Number Expiry Date

Start Date The Last 3 Digits of Security code on reverse of Card TWI Certification Ltd Bank Details:

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CSWIP/5YR/2015

Please ensure that when you are making a Bank Transfer that you pay all bank charges, ensuring that TWI Certification Ltd receives exactly what is required from you. Please also ensure that the Bank clearly gives: • Your Name • Your Certificate Number • Date the money was transferred BARCLAYS BANK PLC, MARKET PLACE, SAFFRON WALDEN, ESSEX, CB10 1HR, UNITED KINGDOM STERLING A/C STERLING A/C: SWIFT CODE: CODE:

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60919349 IBAN CODE GB36 BARC 2074 0560 9193 49 BARC GB22 20-74-05

CSWIP/5YR/2015

PAYMENT BY COMPANY: If Payment is being made by a Company Cheque or Credit Card then please provide full company details including contact name and company email address with your application. Company Name Contact Name Address

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Telephone Number Company Email CHECKLIST FOR APPLICATION All of the Items that are listed in the Checklist below must be produced for your application to be successful. Please tick the Items that you have enclosed. Items Enclosed 1 . 2 .

3 .

4 . 5 . 6 . 7 .

8

TICK 

Candidates Details Method of Payment

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Credit Card Details Provided Copy of Bank Transfer and state date transfer was sent

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Cheque/demand draft enclosed. Payable To: TWI Certification Ltd in Pounds Sterling

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Log Sheets/ Book (Signed and stamped) by your employer(s) In order to successfully renew your CSWIP qualification it is a requirement that you provide at least 4 out of the last 5 years verified work experience. Continuing Professional Development Form Record of Experience (Give details for your current or most recent employer) One Current Passport Size Photograph of yourself taken within the last 2 years An original document, giving results of an eyesight test taken within the last 2 years, confirming that you have taken a near vision sight test. Your optician must clearly state that your vision meets one of the following standards: Either aided or un-aided you can read Times Roman point size N4.5 or Jaeger point size J1 at a distance of not less than 30cms. For your convenience a form for this is attached.

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The CSWIP Certificate that you are applying to renew

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CSWIP/5YR/2015

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(Photocopies of this certificate are accepted)

When complete please submit your application by post to: TWI Certification Ltd, Granta Park, Great Abington, Cambridge, CB21 6AL, United Kingdom 3. Log sheets RENEWAL OF CSWIP CERTIFICATES GUIDANCE NOTES ON COMPLETING THE LOG SHEET In order to qualify for renewal, you will need to demonstrate that you have carried out satisfactory work activity with reasonable continuity during the previous five years. “Reasonable continuity” means that an absence of change or activity (preventing you from practising the duties corresponding to your certificate) for one or several periods during the validity of the certificate does not exceed a total of one year. Certificate holders not able to satisfy the continuity rules will be treated as initial candidates. For more information and guidance on completing the CSWIP Log Sheets then please visit: www.cswip.com

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CSWIP/5YR/2015

EMPLOYMENT LOG SHEET –(Please complete a log sheet for each employment)

CANDIDATE’S NAME: DATE OF BIRTH: Company name & address: Dates of employment or contract: From: (DD/MM/YY)

To: (DD/MM/YY) TILL DATE

Position held: Brief outline of work carried out for this company:

Declaration: I (Name and position held in above company)

SIGNATURE & STAMP

Hereby declare that I have knowledge of the above applicants work activities. That the information given above is correct and that I am suitably qualified to verify this information. Verifiers Professional Relationship to applicant:

Date:

Verifiers Company E-Mail address: Verifiers Company telephone number:

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CSWIP/5YR/2015

4. CONTINUING PROFESSIONAL DEVELOPMENT (CPD) CSWIP Inspectors are required to keep themselves up-to-date with technical developments in their field within the Industry. Continuing Professional Development is required for your CSWIP Renewal. A minimum of 35 hours of CPD per year must be shown. Professional development may be achieved in any of the following ways, depending on your personal circumstances, learning style and opportunities available to you.        

Private Study: Such as distance learning, Open University, Writing papers, Reading, Research on the internet/journals etc. Short Courses: Attendance at short courses, seminars and presentations Attending Conferences, symposia and exhibitions Additional Study: Learning foreign languages, new computer skills etc. WJS/Professional Membership Meeting (non-social): Attendance at branch or technical meetings/webinars Further Education Studies Imparting knowledge: Making presentations, preparation of papers accepted for conferences/publications, coaching/teaching/lecturing

Please indicate how you have kept up-to-date with developments in welding technology over the last five years.

Please Note: If a professional member you have the option to use the online CPD system www.twiprofessional.com

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CSWIP/5YR/2015

5. Record of Experience INSPECTION EXPERIENCE Visual/Welding/Senior/Plant Inspectors & Welding Quality Control CoOrdinators This section should record the principal features of your job and show your specific inspection responsibilities as indicated below. (To be completed by the listed certificate holder only) Principal Products/Activities Materials Involved Welding Processes Used Codes and Standards Involved -

NDT EXPERIENCE For NDT Personnel Only This section should record the principal features of your job and show your specific NDT responsibilities as indicated below. (To be completed by NDT Certificate holders only) Principal Products/Activities Materials Involved NDT Techniques Used Codes and Standards Involved -

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CSWIP/5YR/2015

TWI CL Eye Test form Name of individual tested Date Of Birth Address

RESULT OF NEAR VISUAL ACUITY TEST

Please record the smallest text capable of being read by the above named on a standard reading test chart at a distance of no less than 30cm using Times Roman or Jaeger Text. Uncorrected Corrected (With the use of Glasses) Times Roman Point Size: N

Times Roman Point Size: N _________

Or

Or

Jaeger Point Size: J______

Jaeger Point Size: J_____

Note for tester: For this persons occupation he/she must be able to read Times Roman Point N4.5 or Jaeger Point J1. Please record the results of the near vision eyesight test above left, but if he/she cannot meet this standard with eyes uncorrected please test the vision again using his/her glasses and record the results above right. DETAILS OF PERSON PERFORMING THE ABOVE TEST:

Date of Test:

Print Name of Person who Performed the above Test:

Signature of Tester:

Email address of tester:

Profession please tick: Optometrist Medical Doctor Registered Nurse Certified to ISO 9712 Level 3 Other (please specify)

Emboss official stamp here -

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CSWIP/5YR/2015

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CSWIP/5YR/2015