Revised 02/12/18 cc

CWS CHECKLIST

READ FIRST AND FOLLOW THESE INSTRUCTIONS CAREFULLY THE APPLICANT IS RESPONSIBLE FOR PROPER SUBMITTAL

1. Choose a class start date.

2. Complete the AWS® CWS® Certified Welding Supervisor Initial Exam Application at least six (6) weeks before the examination date. (If this is not filed on time, a late fee will be charged by AWS®.)

Box 1 – Check here if taking any seminar prior to the exam Name of Training Provider: Hobart Institute of Welding Technology Location: Troy, OH Date: indicate date of CWS550 course

Box 3 – Payment must accompany your application

AWS® member - $520.00

Non-member - $600.00 3. Mail the Exam Application, supporting documents (if required), and payment to:

American Welding Society Certification Business Unit 8669 NW 36 St., Suite 130 Miami, FL 33166-6672

(It is suggested that you send the application via UPS, FEDEX, or registered mail so that the packet may be tracked.)

AWS® has made a change to the CWS® examination process. The CWS® exam is now only given at Prometric test centers using computer based testing. There are Prometric test centers located all over the

United States. Visit the AWS website to become familiarized with the Prometric computer based testing at www.aws.org. There will be an eligibility I.D. # on the confirmation letter that you receive from AWS®. You will need this number when scheduling your test with Prometric.

There is a Prometric test site approximately 30 minutes from Hobart Institute of Welding Technology.

4. Complete and submit the Hobart Institute Technical Training Agreement/Enrollment Form

Mail: Hobart Institute of Welding Technology

400 Trade Square East Troy, OH 45373

Fax: 937-332-9550

Email: financial@welding.org OR

Apply Online @ www.welding.org

Payment – cost of 4-day CWS550 course - $950.00

Checks and Purchase Orders must be made out to: Hobart Institute of Welding Technology

Credit Card payments will be made through the online Student Portal via a link provided in your confirmation email

NOTE: We cannot register anyone over the telephone. We must have a signature for registration.

5. Hobart Institute will supply the books for the class. Also, bring with you a noiseless calculator. (Calculators are

not available in our bookstore.) You may not use any electronic device, including cell phones, in place of a calculator. Call 937-332-9500 for any additional information.

CWS Exam Application_1139 Page 1 of 5 August 16, 2017

CWS- Certified Welding Supervisor

Initial Exam Application

NOTE

This exam will be offered all over the US in convenient locations using computer based testing with our partners at Prometric. After your application has been submitted and approved, you will be provided with an Authorization to Test (ATT) Letter in order to schedule your appointment through Prometric at one of their centers.

Last Name First Name Middle Initial

Street Address City, State, Zip Code

Home Telephone Work Telephone Mobile Telephone

Email Date of Birth MM/DD/YY Last Four Digits of SS#

1. Check and Complete the Following: Have you obtained an AWS Certification? Yes No If yes, Certification #: ______________________________ Are you an AWS Member? Yes No If yes, Member #: _________________________________

Check here if taking any seminar prior to the exam.

Name of Training Provider _____________________________________________________________________________________________

Location ____________________________________________________ Date __________________________________________________

2. American with Disability Act Accommodations

By checking this box I am requesting special accommodations due to a disability. AWS is committed to complying fully with the ADA. Click here for a copy of the accommodations request package or visit our web http://www.aws.org/certification Will you be using a glucose meter during your exam? Yes No

3. Method of Payment- all checks and money orders should be made payable to AWS. AWS USE ONLY Payment must accompany your application Acct #:

Check or money order #_______________________

VISA MC AMEX Discover CVV: _________ Date: AMT$:_______________________CWS

CC#: / / / Exp: / SIGNATURE:___________________________________________________________ Click here for current fees

Pricing Initial Exam Member Non-Member Exam $400 $480 Prometric Seating Fee $120 $120 TOTAL $520 $600

8669 NW 36 St., #130 Miami, FL 33166-6672 (800) 443-9353 or (305) 443-9353, ext. 273

Faxed or emailed applications are NOT accepted

Name AWS Member No.

CWS Exam Application_1139 Page 2 of 5 August 16, 2017

4. Associations

Type of Business (check only ONE)

A Contract construction

B Chemicals & allied products

C Petroleum & coal industries

D Primary metal industries

E Fabricated metal products

F Machinery except elect. (incl. gas welding)

G Electrical equip., supplies, electrodes

H Transportation equip. - air, aerospace

I Transportation equip. - automotive

J Transportation equip. - boats, ships

K Transportation equip. - railroad

L Utilities

M Welding distributors & retail trade

N Misc. repair services (incl. welding shops)

O Educational Services (univ., libraries, schools)

P Engineering & architectural services (incl. assns.)

Q Misc. business services (incl. commercial labs)

R Government (federal, state, local)

S Other

Job Classification (check only ONE)

01 President, owner, partner, officer

02 Manager, director, superintendent (or assistant)

03 Sales

04 Purchasing

05 Engineer — welding

06 Engineer — other

07 Inspector, tester

08 Supervisor, foreman

09 Welder, welding or cutting operator

10 Architect, designer

11 Consultant

12 Metallurgist

13 Research & development

14 Technician

15 Educator

16 Student

17 Librarian

18 Customer service

19 Other

20 Engineer - design

21 Engineer - manufacturing

22 Quality Control

Technical Interests(check ALL that apply)

Ferrous metals

Aluminum

Non-ferrous except aluminum

Advanced materials/intermetallics

Ceramics

High energy Processes

Arc Welding

Brazing & Soldering

Resistance Welding

Thermal Spray

Cutting

NDT

Safety & Health

Pipe & Tubing

Pressure Vessels & Tanks

Structures

Roll Forming

Sheet metal

Stamping & punching

Bending & shearing

Aerospace

Automotive

Machinery

Marine

Other

Automation

Robotics

Computerization of Welding

Name AWS Member No.

CWS Exam Application_1139 Page 3 of 5 August 16, 2017

5. Education – Please check if you meet the following requirement:

6. Qualifying Work Experience - Resumes NOT Accepted Requirement: A minimum three (3) years of practical welding experience in a fabrication, construction or welding related industry. For alternatives experience qualifications, refer to the AWS B5.9 Specification for the Qualification of Welding Supervisors by visiting our website .

_______ I understand that all work experience documented on this application may be verified with both past and

present employers. PLEASE DUPLICATE THIS PAGE IN ORDER TO MEET THE WORK EXPERIENCE REQUIREMENTS FOR CWS

PLEASE DUPLICATE THIS PAGE IN ORDER TO MEET THE WORK EXPERIENCE REQUIREMENTS FOR CWS

Applicants applying for the CWS examination must have a high school diploma or have obtained a state or military approved high school equivalency diploma.

Company Name Type of Business Company Phone Number

Company Street Address City, State, Zip Code

Supervisor’s Name Title of Immediate Supervisor

Supervisor’s Email Address Department

Applicant’s Job Title Employed From: (Mo.) (Yr.)

To: (Mo.) (Yr.)

Job Responsibilities- Detailed Description Required*

Company Name Type of Business Company Phone Number

Company Street Address City, State, Zip Code

Supervisor’s Name Title of Immediate Supervisor

Supervisor’s Email Address Department

Applicant’s Job Title Employed From: (Mo.) (Yr.)

To: (Mo.) (Yr.)

Job Responsibilities- Detailed Description Required*

Name AWS Member No.

CWS Exam Application_1139 Page 4 of 5 August 16, 2017

7. Employment Verification

This section MUST be completed by a supervisor or personnel manager from the most recent employer. If self-employed or contract applicant you must substitute this section with a letter of reference on company letterhead from two (2) separate clients attesting to the nature of work assignments during the period of performance.

IF THE EMPLOYER IS NO LONGER IN BUSINESS, PLEASE INCLUDE A COPY OF THE W2 FORM.

Company Name Company Phone

Company Address

City, State Zip Code Country

I , verify that maintained

employment at from to .

Signature Date

8. Photo Requirements

Applicants MUST submit one (1) passport-style color photograph. Please print your name and membership number (if applicable) on the reverse of the photograph. Your photo is a vital part of your application. To learn more, review the information on how to provide a suitable photo to avoid processing delays by visiting our website. The acceptance of your photo is always at the discretion of the AWS.

Supervisor/Personnel Manager’s Name (print)

Company Name

Supervisor/Personnel Manager

Employee’s Name (print)

Date mm/yyyy Date mm/yyyy or Present

Photo Requirements: Must be in color. Printed on photo quality paper. 2 x 2 inches (51 x 51 mm) in size. Sized such that the head is between 1 inch and 1 3/8 inches

(between 25 and 35 mm) from the bottom of the chin to the top of the head.

Taken within the last 6 months to reflect your current appearance. Taken in front of a plain white or off-white background. Taken in full-face view directly facing the camera with a neutral

facial expression and both eyes open.

Name AWS Member No.

CWS Exam Application_1139 Page 5 of 5 August 16, 2017

9. Proof of Identity Please attach a color copy of your current Government issued ID to this application, such as a driver’s license or passport.

10. Terms and Conditions – Please check, Date, and Sign below

CERTIFIED WELDING SUPERVISOR QC13 Standard for AWS Certification of Welding Supervisors. B5.9 Specification of Qualification of Welding Supervisor.

I hereby certify that I have read the standard requirements contained in the certification programs indicated above. Further, I agree to comply with the existing requirements and any subsequent requirements that may be instituted by AWS. I have read and agree to the terms and conditions set forth in the AWS Policies and Fees form. I certify that the information I have included on this application is true. I understand that any false statements will nullify this application. I give AWS permission to verify this information. I agree to comply with the provisions set forth in the Standard concerning the administration of my examination and certification. Upon obtaining my certification, I give AWS the right to reveal my certification status as it relates to my validity and expiration date. I further understand that any required information that is incomplete or missing will cancel this registration.

Furthermore, I certify that I have not obtained any exam materials, have no prior knowledge of the AWS exam questions or answers, and have not and will not accept any solicitation for the AWS exam questions or answers from anyone at any time before, during, or after the exam as stated on the Exam Security Agreement and General Terms of Use (Please click and read this link prior to accepting the Terms and Conditions. You will be required to sign this form on exam day). I understand that a violation of this oath may be grounds for invalidation of my certification and may be grounds for expulsion from any future testing.

Applicant’s Signature Date

AWS Policies and Fees -Please visit our website

Employment Verification _0001 Page 1 of 1 August 23, 2017

EMPLOYMENT VERIFICATION

Account # Order# Site Code Exam Date

Last Name First Name MI

Address Apt #

City and State / Province / Country Zip Code

Home Telephone Number Work Telephone Number Mobile Telephone Number

Date of Birth (example November 30 1952) U.S. Social Security Number (last 4 only)

X X X X X

E-Mail Address (confirmation notification will be sent to this address)

Employment Verification

• This section MUST be completed by a supervisor or personnel manager for the most recent or current employer indicated above.

• Self-employed or contract applicants must substitute this section with a letter of reference on company letterhead from two (2) separate clients attesting to: o the nature of work assignments during the period of performance o type of work done o length of time as a client

• If the employer is no longer in business, include a copy of the W2 form.

Company Name: _______________________________ Company Phone:_____________________________________

Company Address: __________________________________________________________________________________

City, State: ______________________________________ Zip Code:___________________ Country: ______________

I ____________________________________ , verify that _________________________ maintained employment at

______________________________________________ From_______________________ to __________________

Signature: __________________________________________________ Date: ___________________________

Faxed or emailed applications are NOT accepted 8669 NW 36 St, #130 Miami, FL 33166-6672 (800) 443-9353 extension 273

Month Day Year

Supervisor/Personnel Manager’s Name (print)

Month/Day/Year

Supervisor/Personnel Manager’s Name (print)

Employee’s Name (print)

Company Name

Date mm/yyyy

Date mm/yyyy or Present

mm/dd/yr

Name: Account #:

Additional Qualifying Work Experience

QWE form May 1, 2012

Company Name Type of Business Company Phone Number

Company Street Address City, State, Zip Code

Supervisor’s Name Title of Immediate Supervisor

Supervisor’s Email Address Department

Applicant’s Job Title Employed From: (Mo.) (Yr.)

To: (Mo.) (Yr.)

Job Responsibilities- Detailed Description Required*

Company Name Type of Business Company Phone Number

Company Street Address City, State, Zip Code

Supervisor’s Name Title of Immediate Supervisor

Supervisor’s Email Address Department

Applicant’s Job Title Employed From: (Mo.) (Yr.)

To: (Mo.) (Yr.)

Job Responsibilities- Detailed Description Required*

Company Name Type of Business Company Phone Number

Company Street Address City, State, Zip Code

Supervisor’s Name Title of Immediate Supervisor

Supervisor’s Email Address Department

Applicant’s Job Title Employed From: (Mo.) (Yr.)

To: (Mo.) (Yr.)

Job Responsibilities- Detailed Description Required*

Photo Identification Card September 22, 2017

AWS Certification Photo Requirements

AWS adopts the same guidelines for photos as does the U.S. Department of State for passport photos

(see link). The acceptance of your photo is at the discretion of the AWS, please review the AWS photo

requirements before submitting your photo.

Your photo is a vital part of your application. To learn more, review the information below on how to provide a suitable photo to avoid processing delays. The acceptance of your photo is always at the discretion of the AWS.

We recommend you use a professional passport photo service to ensure your photo meets all the requirements.

If you are applying for a Certification, you must provide one (1) passport-style photograph. Your photo must be:

• In color • Printed on photo quality paper • 2 x 2 inches (51 x 51 mm) in size • Sized such that the head is between 1 inch and 1 3/8 inches (between 25 and 35 mm) from the

bottom of the chin to the top of the head. • Taken within the last 6 months to reflect your current appearance • Taken in front of a plain white or off-white background • Taken in full-face view directly facing the camera • With a neutral facial expression and both eyes open • Taken in clothing that you normally wear on a daily basis:

o Uniforms should not be worn in your photo, except religious clothing that is worn daily. o Do not wear a hat or head covering that obscures the hair or hairline, unless worn daily

for a religious purpose. Your full face must be visible, and the head covering must not cast any shadows on your face.

o Headphones, wireless hands-free devices or similar items are not acceptable in your photo.

o If you normally wear prescription glasses, a hearing device or similar articles, they may be worn for your photo.

o Dark glasses or non-prescription glasses with tinted lenses are not acceptable unless you need them for medical reasons (a medical certificate may be required)

o Glare on glasses is not acceptable in your photo. Glare can be avoided with a slight downward tilt of the glasses or by removing the glasses or by turning off the camera flash.

Digitial Images:

• Dimensions: The image dimensions must be in a square aspect ratio (the height must be equal to the width). Minimum acceptable dimensions are 600 x 600 pixels. Maximum acceptable dimensions are 1200 x 1200 pixels.

Photo Identification Card September 22, 2017

• Color: The image must be in color (24 bits per pixel) in sRGB color space which is the common output for most digital cameras.

• File Format: The image must be in JPEG file format.

• File Size: The image must be less than or equal to 240 kB (kilobytes).

• Compression: The image may need to be compressed in order for it to be under the maximum file size. The compression ratio should be less than or equal to 20:1.

Scanned Images:

• 2 x 2 inches (51 x 51 mm)

• Scanned at a resolution of 300 pixels per inch (12 pixels per millimeter)

Photos copied or digitally scanned from driver’s licenses or other official documents are not acceptable. In addition, snapshots, magazine photos, low quality vending machine or mobile phone photos, and full-length photographs are not acceptable.

Want to take the photo yourself?

While we recommend you use a professional passport photo service to ensure your photo meets all the requirements, you may take the photo yourself. Hand-held self-portraits are not acceptable. Photos must not be digitally enhanced or altered to change your appearance in any way. Please use reliable references for guidance on taking your own photo. There are several online software tools for this purpose. It is your responsibility to ensure the tool you use produces a photo that meets AWS specifications.

Renewals/Recertification - Change of Appearance

If you cannot be identified from your current photo on file with AWS, you should submit a new photo with your renewal or recertification application.

Examination results will NOT be released until we receive the 2 x 2 inch color passport-style photograph. To avoid delays in receiving your examination results, please mail your photo to the address listed below:

American Welding Society Certification Department Photo Center 8669 NW 36 Street Suite 130 Miami, FL 33166-6672

We recommend using priority mail with tracking options.

For question or concerns, please call the Certification Department 800-443-9353, extension 273.

2018 Price List

Certification Price List_2236 February 5, 2018

Inspector (CAWI, CWI, SCWI) Price Member *Non-Member

Initial CAWI, CWI Exam - Add CWE Exam

850 140

1065 ***140

CWI by Reciprocity with CWB or INWC Upgrade CAWI to CWI Prometric Initial SCWI Endorsement Structural Drawing Reading

500 240 970 275

715 455 1185 490

Prometric Endorsement Exam ^^ Prometric Endorsement MT/PT Exam(Per Part A&C)^

335 395

550 628

Endorsement MT/PT Exam(Part B)^Contact ATF for pricing

Retest Member * Non-Member

CAWI, CWI, CWE or CWI/CWE (Per Part) 275 ***275 CAWI, CWI, CWE or CWI/CWE (All Parts) 595 810 Prometric SCWI Prometric Endorsement MT/PT (One Part A or C)^ Prometric Endorsement MT/PT (Two / Three Parts)^ Endorsement MT/PT Exam(Part B)^ Contact ATF for pricing

715 335 395

930 568 628

Packages Member * Non-Member

CWI Seminar and Exam Package (D1.1 Focus) - Add CWE Exam - CWI Pre-Seminar(online course)

2385 140 750

2618 ***140 ***750

CWI Seminar and Exam Package (API 1104 Focus) - Add CWE Exam - CWI Pre-Seminar(online course)

2385 140 750

2618 ***140 ***750

Clinics / Seminars / Workshops (Exam not Included) Member * Non-Member

CWI Seminar Week (D1.1 Focus) 1865 2098

CWI Seminar Week (API 1104 Focus) 1865 2098

Seminar Retake (within 12 months of original event) 845 845

CWI Pre-Seminar (online course) 865 ***1150

Welding Fundamentals I (online course) ► 350 ***470

Renewal Prices Member * Non-Member

CWI/SCWI 3rd and 6th Year Renewal by work Experience 470 685

CWI/SCWI 3rd and 6th Year Renewal by Examination 745 960

CWB or INWC Renewal by Reciprocity 430 645

9-Year Recertification Price Member * Non-Member

CWI Part B Exam 870 1085

SCWI Part A & B Exams 990 1205

Prometric CWI/SCWI Endorsement Exam^ Prometric Endorsement MT/PT (Per Part A&C)^

930 395

1145 628

CWI/SCWI Endorsement Structural Drawing Reading Exam 870 1085

CWI/SCWI Non-Exam

• 80 Professional Development Hours (PDHs)

• Endorsement Exam Prior to 9th year of certification period

• Initial CRI Certification

•

595 810

CWI/SCWI 9yr Course Endorsement MT/PT Exam(Part B)^ Contact ATF for pricing

1705

1938

* Non-Member price includes a 3-year AWS Individual Membership unless otherwise noted.

** Non-Member price includes a 1-year AWS Individual Membership.

***No additional membership included with this price.

^ Additional ATF fees will apply for the practical exam (part B). Prices reflect a $60 seat fee per part for

Prometric initial and/or reexam endorsements. Contact the ATF for Pricing.

^ Price is for all endorsements except Structural Drawing Reading. ► For a complete price list of our online courses please visit awo.aws.org. Some online courses can be combined with other certification programs. Note: Prices are subject to change without notice. Full payment must be received with your completed application or it will not be processed. All checks, money orders and demand drafts must be made payable to: American Welding Society

Certified Welding Educator (CWE) Price

Member *Non-

Member

Exam Only 635 850 Non-Exam 360 575

Retest 315 530

Renewal 305 520

AWS SENSE Participants Only Exam 275 490

Retest 315 530 Retest (Single Part) 275 ***275 CWI/CWE Exam 470 685

Renewal CWE Only 200 415

Certified Radiographic Interpreter (CRI) Price

Member *Non-

Member

Exam 750 965

Seminar Only

1407 1640

Seminar and Exam 1758 1991

Retest (All Parts) 550 ***550

Retest (Per Part) 275 ***275

Renewal 9yr Recertification (Part B)

445 720

660 935

Certified Welding Supervisor (CWS) Price

Member Non-

Member

Prometric Exam 520 **600

Prometric Retest (Per Part) 335 ***335

Renewal 305 **385

Prometric 9yr Recertification Exam (A&B) 488 **580

9yr Recertification PDHs 336 **420

Certified Welding Sales Representative (CWSR) Price

Member Non-

Member

Prometric Exam 335 **415

Prometric Retest 335 **335

Renewal 275 ***275

Certified Welding Engineer (CWEng) Price

Member *Non-

Member

Part 1 & 2 Exam 400 **480

Part 3 & 4 Exam 400 **480

PE Exemption 350 565

Retest (per part) 200 **280

Renewal 445 660

Certified Robotic Arc Welding (CRAW) Price

Member *Non-

Member

Technician/Operator Exam or Retest 350 565

Operator to Technician Upgrade 100 **100

Technician/Operator Renewal 200 415

Certified Welder (CW) Price

Member *Non-

Member

Certified Welder Application 50 ***50

Maintenance of Welder Certification 25 ***25

AWS Policies and Fees AWS Bank Information

AWS Policies and Fees

AWS Policies and Fees January 29, 2016

8669 NW 36 St, # 130 Miami, FL 33166-6672

(305)443-9353 (800)443-9353 ext 273 Fax (305)443-6445

Email: certification@aws.org Website: http://www.aws.org

IMPORTANT NOTICE!! “No Show” Penalty - All fees paid to AWS are forfeited if a candidate fails to submit the cancel or reschedule request on time. Also, it applies if you arrive late, arrive unprepared (i.e. missing proper ID, wrong codebook etc.) or do not show up to the seminar and/or exam.

Processing Fee The processing fee is included in all certification price list fees. If a candidate does not meet the qualification requirements or cancels their event registration, a refund is issued minus the $75 processing fee.

Application and Fast Track The Application Submission Deadline is six (6) weeks prior to the week of the scheduled seminar/exam or exam date. Please refer to the seminar/exam schedule to confirm the submission deadline date. An application received after the submission deadline and/or fees paid in full after the submission deadline date, but no later than thirteen (13) business days prior to the week of the event is processed for the requested test site if space is available. $350 Fast Track Fee is charged for this service and non-refundable. Full payment for the application and Fast Track fee is required in order to be processed and complete registration. Please do not make travel or hotel arrangements prior to receiving a confirmation letter for the seminar/exam or exam.

Rescheduling — Seminar and/or Exam The Certification Department must receive a Change of Site/Cancellation form via email or fax. Only one (1) rescheduling request received will be processed without charge, but the request must be submitted no later than thirteen (13) business days prior to the week of the event. Any other rescheduling requests received will be charged a non- refundable rescheduling fee and must be paid in full prior to your rescheduling request being processed. The rescheduling fees are as follows:

*Only one (1) reschedule request processed at no charge

Cancellation — Seminar and/or Exam The Certification Department must receive a Change of Site/Cancellation form via email or fax. Only one (1) cancellation request received will be processed without charge, but the request must be submitted no later than thirteen (13) business days prior to the week of the event. Any additional cancellation requests will receive a refund minus a cancellation fee. The cancellation fees are as follows:

*$75 processing fee applied

Seminar Only – Remove or Add-on If you would like to add, reschedule, or cancel the seminar only portion, you must contact the Education Department at ext. 455 for further assistance.

AWS American Welding Online Course (AWO) If you would like to cancel your online course or have technical issues, please contact the Education Department at ext. 455 for further assistance.

Refunds Refunds will be credited back to the original payment even if the account is closed or paid in full. Reschedule and cancellation requests can be made by the applicant only. Employers supporting an applicant’s fees cannot request a refund for fees paid.

All fees are Nontransferable. Fees are subject to change without notice. AWS reserves the right to cancel any seminar and/or exam if there are an insufficient number of participants. In the event of cancellation by AWS, all seminar/exam fees will be refunded in full, or the participant may transfer to the next available seminar or exam. In either case, AWS shall have no further liability.

In accordance with the Americans with Disabilities Act (ADA), AWS strives to accommodate all participants with special needs. If you require assistance, you must complete and submit the ADA Accommodations Request package. This package must be received no later than the application deadline date.

13 Business days or more prior to start of event week

Prior to start of event week but less than 13 business days

Event week “No show”

Seminar Only No Charge $350 Forfeit all Fees

Exam Only $250* $250 Forfeit all Fees

Seminar and Exam $250* $600 Forfeit all Fees

13 Business days or more prior to start of event week

Prior to start of event week but less than 13 business days

Event week “No show”

Seminar Only No Charge* $550 Forfeit all Fees

Exam Only $250* $250 Forfeit all Fees

Seminar and Exam $250* $800 Forfeit all Fees

Veterans Benefits VA Benefits Can Cover Your Certification Test Costs If you're a veteran with G.I. Bill Benefits and seeking a new job or striving to move ahead in your

present job, don’t miss the opportunity to strengthen your career opportunities and earnings with

additional licensing or certification. As an eligible veteran, you may be reimbursed for your test

costs.

VA licensing and certification benefits: The new licensing and certification benefit allows the Department of Veterans Affairs (VA) to pay

you, if you're eligible, for a test for a license or certification, including several offered by AWS. You

can receive reimbursement for approved licensing or certification tests you take on or after March 1,

2001. These tests must be specifically approved for the G.I. Bill.

Note: The VA covers only the cost of the test itself. You may be responsible for other fees connected with

obtaining certification.

How Do I Apply For Benefits?

The first step is to take the test for your desired certification. With test results in hand, you can then

apply for test cost reimbursement from the VA. You will need to complete and submit the Application

for Licensing and Certification Testing Fee Reimbursement to the VA office that handles your

education benefits.

Check the map on the Internet site at www.gibill.va.gov to find the location nearest you.

Never filed a claim for VA education benefits before?

You’ll also need to submit an application for benefits. Check below to find the correct form for your

needs. You can print either one directly from the VA’s website or call 1-888-GIBILL-1 (1-888-442-

4551) to request the form by mail.

• Veteran or on active duty? Use VA Form 22-1990, which you can complete and submit right

online. Visit www.gibill.va.gov and click Electronic Application.

• Eligible child or spouse of a veteran? You need VA Form 22-5490.

Send the application form along with the other information above to the VA regional office that

processes your claim. The addresses are printed right on the forms.

1 of 2

TECHNICAL TRAINING AGREEMENT/ENROLLMENT FORMEFFECTIVE JANUARY 1, 2018

To register visit www.welding.orgaddress listed below. NOTE: See cancellation policy on reverse side of this page.

HOBART INSTITUTE OF WELDING TECHNOLOGY, 400 TRADE SQUARE EAST, TROY, OH 45373, U.S.A

(937) 332-9500 - FAX (937) 332-9550 - E-MAIL financial@welding.org

Name __________________________________________________ Social Security Number _____________________ First Middle Initial Last

Street __________________________________________________ Area Code & Telephone_____________________

City _________________________ State____________ Zip Code__________________ Country____________________

Date of Birth______________ M / F_____________ Military Veteran ___Y ___N (mm/dd/yyyy)

(Check all that apply.) ETHNICITY: ___Hispanic/Latino ____ Non-Hispanic/Latino RACE:_____Hispanic/Latino ___American Indian or Alaskan Native ____Asian

International Students, please provide Country or Nationality _____________________________________ Country of Birth_____________________________________

Employed by: ______________________________________________________________________________________

Address ____________________________________________________ Area Code & Telephone__________________

City__________________________________________State_________________Zip Code________________________

We Accept MasterCard, VISA, American Express, and Discover (See reverse side)Please note: Checks and Purchase Orders should be made out to Hobart Institute of Welding Technology.

I wish to enroll in the certificate program or continuing education course(s)/seminar(s) checked below: Desired AlternateCourse number Description Tuition date date____VI400 Fundamentals of Visual Inspection

____NW515 Welding for the Non-Welder

____AWI520 Arc Welding Inspection

____LP800 Liquid Penetrant & Magnetic Particle Inspection

____CWS550 Preparation for AWS® CWS Examination Course

____CWI540 Preparation for AWS® (CWI®/CWE®

Inspector/Educator Examination Course

____RCW545 ® Course

____CWI540-C Preparation for AWS® CWI® Code Endorsement

____SPE025 Specialized Welding Training (QUOTATION UPON REQUEST)

I acknowledge that I/we have a copy of this agreementread and understand the Cancellation Policy

form upon acceptance by the Hobart Institute of Welding Technology.

Intellectual Property. All PowerPoint® presentations, videos, tests and class materials are the intellectual property of Hobart Institute of Welding Technology. I will not copy, photograph or visually record any intellectual property of Hobart Institute of Welding Technology. I

Liability release. While visiting or attending classes at Hobart Institute of Welding Technology, I agree that Hobart Institute of Weldng

Consent to receive documents electronically. I authorize the Hobart Institute of Welding Technology, Troy, Ohio 45373 to deliver all

Photo release.remain the property of the Hobart Institute of Welding Technology. The Hobart Institute of Welding Technology may use these materials in its entirety or in part. The materials may be used in various forms of media, including print, video, or audio.

How or from whom did you originally hear about Hobart Institute of Welding Technology? _______________________________________Applicant’s Signature _____________________________________________________________Date______________________________

Email address ____________________________________________________________________________________

Hobart Institute of Welding Technology updates by email? ___Yes ___ No

NOTE: Technical courses do not require a $125.00 registration fee.No audio or audio-visual recording of classes will be permitted.

Class begins at 8:00 a.m. Please refer to your confirmation for exact starting time. Both sides of this form constitute the agreement - please be sure this agreement is signed above.

GENERAL INFORMATION AND CANCELLATION POLICIES FOR TECHNICAL TRAINING

EFFECTIVE JANUARY 1, 2018

Cancellation policy:

in a handling charge of $100.00. Failure to notify of non-attendance or a “No-show” on the assigned starting date will result in forfeiture of all payments of tuition for that class.

to the next available starting date for the same course.

does not and will not discriminate on the basis of disability, race color, religion, sex, national origin, or age regarding admission or access to its programs and activities.

Purchase order policy: If tuition is invoiced against a purchase order, a copy of the purchase order must accompany the enrollment form. Terms are NET 30 on all invoiced training.

Housing and meals: Students are responsible for their own housing and meals. The Institute does not have food

are several restaurants near the Institute. Access our Website at www.welding.org, or contact the Institute at 937-332-9500 for information about restaurants, hotels, and campsites.

Insurance and Medical Care: Students are responsible for their own medical care and expenses. Students are not covered by Hobart Institute of Welding Technology insurance or industrial compensation.

Safety and health: We do not permit tobacco use inside the Institute for the safety and health of other students and staff. However, the Institute does provide designated areas outside the facility for tobacco users. Shorts and open-

toed shoes or sandals are not permitted in any Hobart Institute of Welding Technology classroom or lab.

NOTE: Hobart Institute of Welding Technology has a no firearms policy; no person shall possess, photos/

video have under their possession or control, convey or attempt to convey, a deadly weapon or dangerous

ordnance onto Hobart Institute of Welding Technology premises.

2 of 2

Both sides of this form constitute the agreement. Please be sure this agreement is signed prior to submitting.

For security and compliance purposes,

credit card information will no longer be accepted via email or fax.

Payment can be made via credit card after you have received your registration confirmation email by calling 937-332-9500 or

online by logging onto the student portal at

https://www.welding.org/hiwt-my-portal-login/

Elm

St .

75

Piqua

Miami Valley

Centre Mall

Nort

h 7

5

Experi

me

nt F

arm

Roa

d

41

Exit 74 West Main Street

So

uth

75

75

S. D

ors

et R

d.

N. D

ors

et R

oad

North Road

We

sto

n R

oad

N. R

idge A

venu

eTro

y T

ow

n D

r.

WalMart, Kohls,

Food

Exit 82

Water Street Ad

am

Str

eet

N

S

EW

Comfort Inn

937-778-8100

Hampton Inn

937-339-7801

Holiday Inn Express

937-332-1700 Fairfield Inn

937-332-1446

Residence Inn

440-9303

36East Ash Street

N. N

orw

ich R

oad

Tra

de S

qu

are

W.

Tra

de S

qua

re E

.

Troy

South of TroyDayton Intl. Airport 15 miles

Dayton 20 miles

Cincinnati 74 miles

Comfort Suites

937-339-2525

Hobart Human Resources

Trade Road

Hobart Stick Electrode

Hobart Filler Metals Operation, Troy

Hobart Brothers Customer Service

Student

Parking

Fleet

Sussex

Covent

Croyden

West

brook

Lane

937-332-9500

®

North of TroyToledo 128 miles

Lima 52 miles

Piqua 7.9 miles

Hobart Solid Wire

Visitor

Parking

SussexCoventCroyden

Fleet

N. D

orse

t

Trad

e Sq

. E.

TradeRoad

Wes

tbro

okTr

ade

Sq. W

.

S. D

orse

t

41

W. Main Street

X

EXIT74

Shopping Center

Shopping Center

Ridg

e

North Rd.

Parking

X

XX

XDayton

Cincinnati

Akron

Columbus

Toledo

Cambridge

TROY✈

ClevelandX XX

Check us out on social media!

LIVING IN TROY, OHIO

Motels http://www.welding.org/images/document/207.pdf

Map & Directions http://www.welding.org/t-directions.aspx

Housing available for Hobart Institute of Welding Technology students http://www.welding.org/images/document/205.pdf

City of Troy http://www.troyohio.gov/

Troy Area Chamber of Commerce http://www.troyohiochamber.com/external/wcpages/chamber_index.aspx

Miami County Visitors Bureau http://visitmiamicounty.org/

Hobart Arenahttp://www.hobartarena.com

Miami County Fairhttp://www.miamicountyohiofair.com

Southern Ohio Forge and Anvil Associationhttp://sofablacksmiths.org/

Revised 5/25/2017sds

The Hobart Institute of Welding Technology has arranged special rates at the following

local motels for those attending our courses. Upon making reservations or checking in

at the motel, immediately let them know you will be attending our Institute for the week.

You will be given the special rates listed below. Please make your own reservations.

The approximate taxi fare from the Dayton International Airport, Vandalia to Troy is $40.00 for one person, plus a nominal charge for each additional passenger.

RATES ARE SUBJECT TO CHANGE WITHOUT NOTICE!!

ROOM RATES (Taxes Included)

MOTELS Single Double

COMFORT INN

I-75 at St Rt 36 (Exit 82) Piqua, OH (8 miles N of Troy)

937-778-8100 ** attached to Miami Valley Centre Mall **

Introducing the "Comfort Zone"; alcoholic and non alcoholic beverages,

snacks and sundries available for purchase at the “Comfort Zone”

$81.36

(up to 4 people)

high speed internet

deluxe cont. breakfast

$81.36

(up to 4 people)

high speed internet

deluxe cont. breakfast

FAIRFIELD INN

I-75 at St Rt 41 (Exit 74) Troy, OH

937-332-1446

$96.05

hot breakfast bar

high speed internet

indoor pool

microwave &

refrigerator

shuttle included

(24 hr notice)

$107.35

hot breakfast bar

high speed internet

indoor pool

microwave &

refrigerator

shuttle included

(24 hr notice)

HAMPTON INN

I-75 AT 45 Troy Town Drive (Exit 74)

937-339-7801

$87.94

high speed internet

cont. breakfast

microwave &

refrigerator

$87.94

high speed internet

cont. breakfast

microwave &

refrigerator

HOLIDAY INN EXPRESS

I-75 at St Rt 41 (Exit 74) Troy, OH

937-332-1700

$83.00 1-6 nights

$77 7+ nights

high speed internet

hot buffet breakfast

indoor pool

$83.00 1-6 nights

$77 7+ nights

high speed internet

hot buffet breakfast

indoor pool

RESIDENCE INN BY MARRIOTT

I-75 at St Rt 41 (Exit 74)

937-440-9303

Pricing Studio/Two Bedroom

1-4 nights $132.21/160.46

5-11 nights $120.91/149.16

12-29 nights $100.57/134.47

30+ nights $94.92/128.82

$132.21

hot breakfast bar

high speed internet

kitchen

shuttle included

(24 hr notice)

The mix social hour

(Mon, Tue, Wed)

$160.46

hot breakfast bar

high speed internet

kitchen

shuttle included

(24 hr notice)

The mix social hour

(Mon, Tue, Wed)

Revised 5/25/2017ds

2

Continued

RATES ARE SUBJECT TO CHANGE WITHOUT NOTICE!!

ROOM RATES (Taxes Included)

MOTELS Single Double

BUDGET INN

I-75 at 1330 Archer Drive (Exit 73)

937-339-6564

All Ground Floor Rooms

On-site guest laundry

Next to Lincoln Square Restraunt

$37.28

WiFi

microwave &

refrigerator

Breakfast 6:30a

to 9:00a

$41.80

WiFi

microwave &

refrigerator

Breakfast 6:30a

to 9:00a

Baymont Inn

950 E. Ash Street(Exit 82) Piqua, OH

937-615-0140

Next to Cracker Barrel

Across the street from the Miami Valley Center Mall

Pet friendly (additional $15)

$58.63

free wireless

internet

deluxe cont.

breakfast

pool/whirlpool

microwave &

refrigerator

$58.63

free wireless

internet

deluxe cont.

breakfast

pool/whirlpool

microwave &

refrigerator

COMFORT SUITES

I-75 at St Rt 41,

1800 Towne Park Dr.(exit 74, behind Wal-Mart)

937-339-2525

$79.99

high speed

internet

deluxe breakfast

indoor

pool/whirlpool

microwave &

refrigerator

$79.99

high speed

internet

deluxe breakfast

indoor

pool/whirlpool

microwave &

refrigerator

HOLIDAY INN EXPRESS & SUITES

1110 W. Main St.

Tipp City, OH

937-667-5161

$67.64

high speed

internet

hot breakfast bar

indoor pool

$67.64

high speed

internet

hot breakfast bar

indoor pool

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