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CWB Form 450E/20 23 - 2
WELDING INSPECTOR CERTIFICATION APPLICATION
If you are currently or were previously certified to CSA Standard W178.2, provide your Registration Number:
Level 1 Level 2 Level 3
No (provide documents as per Form 301) Yes No
Check Desired Level of Certification
Are you applying with AWS API TWI-CSWIP certification? Are you applying as an instructor (Clause 8.1.1 e)? Are you applying as a special route candidate (Clause 8.1.1 d)? (^) Yes
FOR CWB USE ONLY
Level Long Exam Short Exam Approved by Date^ Reg #
W178.
IMPORTANT: As the APPLICANT, I understand that applications MUST be completed in full. Incomplete applications can cause delays in processing and may be returned. Certification must be obtained within two years of application approval date. If certification is not obtained, the application will be terminated and I will need to reapply and meet said requirements as stated in Form 301. Form 301, Welding Inspector Application Guide", is an essential and beneficial part of the application process and provides useful information to assist candidates in applying for certification to CSA W178.2.
Applicant's Name:
First Name Middle Name^ Last Name
Tel.: Residence
Address: (^) Tel.: Street
Tel.:
Business
City: Province (^) Postal Code Country
*Email:
The certification fee must accompany application. (USA American Express and Visa Debit are not accepted)
Credit Card #
Name on Card:
Expiry Date:
Security Code:
Have you completed the CWB Education Level 1, 2, or 3 Course Exams? No Yes (provide transcript)
CSA W47.1/CSA W59 CSA W47.2/CSA W59.2 CSA Z
ASME B31.1 ASME B31.3 ASME B31.
CSA W59 Annex U
ASME VIII-1 & IX API 65 0
Signature (Physical/Digital only) Date
Upon completion of the certification requirements, do you wish to have your telephone number published on the CWB
Group's website? YES NO If yes, indicate which number: ______________________________
I hereby confirm that I have read and understood the terms and conditions in Form 301 and that the information provided on this application is true and accurate to the best of my knowledge:
No (^) (See pages 6 & 7)
Cell _*I understand that all official communication moving forward will be sent to me via electronic mail (email) and it is my responsibility to advise the CWB Group of any changes in my email address.
initials_
NOTE: A completed Visual Acuity Record (Form 455) must accompany application form.
Check ONLY ONE Standard/Code to which your certification will apply. (Applies only to candidates applying for Level 1 or Special Route certification ONLY. Code Endorsements are not required when upgrading from Level 1 to Level 2, or from Level 2 to Level 3.
API 65 3
initials
ABS
CWB Form 450E/20 2 3-
Code of Ethics
Certified welding inspectors recognize that precepts of personal integrity and professional
competence are fundamental, and as such shall:
a. have proper regard for the safety, health, and well-being of the public;
b. undertake only those assignments for which they are competent by virtue of
certification, training, and experience and, where warranted, seek the assistance
of specialists as required to complete of assignments;
c. protect to the fullest extent possible any information given in confidence by an
employer or colleague, while being consistent with the well-being of the public;
d. indicate to the employer or supervisor any decisions that have been overruled by
any authority that could result in adverse consequences;
e. be objective, thorough, and factual in any written report, statement, or testimony
about the work and include all relevant or pertinent information in such
documents;
f. sign only for work that they have inspected or for work about which they have
personal knowledge through direct technical control;
g. maintain personal competency by updating their technical knowledge and skills
as required to perform welding inspection properly;
h. comply with the applicable provisions of this Standard relevant to their level of
certification and responsibilities;
i. discontinue all claims to certification upon expiry, suspension, or withdrawal of
certification, and upon request return any certificates and/or wallet cards issued
by the CWB;
j. not perform unethical or dishonest acts or making statements that would
discredit or bring the certification scheme of this Standard into disrepute;
k. not falsify documents, falsely claim, misrepresent or permit misrepresentation or
misuse of their own or other's academic or professional qualifications,
knowledge, training, experience, work responsibilities, or certifications;
l. maintain knowledge of codes or standards applicable to the product or structure
being inspected; and
m. inspect products or structures in accordance with the applicable governing codes
or standards.
Note: The welding inspector should not interfere with the line relationship between
welders, operators, or tackers and their supervisors. When any form of discrepancy
arises, the welding inspector should advise the supervisor or some other responsible
person of the discrepancy.
Applicant's Signature
(Physical/Digital only)
Date (MM/DD/YYYY)
Level 2 Candidates Only CWB Form 450E/20^2 3-
Qualifying Work Experience From:^ To: MM / YYYY
Company Name^ Job Title
MM/ YYYY
Phone
Explain your duties related to welding inspection below. This section must be completed. Additional copies of this page may be used for multiple companies / multiple references, if required. All additional experience pages provided must be signed by your reference. Resumés will not be accepted.
TO BE COMPLETED BY REFERENCE
I confirm that: ^ The above-named candidate has been performing visual welding inspection work for the period indicated above, I was responsible for supervising the above-named candidate’s welding inspection work, I have firsthand knowledge of the above-named candidate’s welding inspection work, and (^) I recommend the above-named candidate for Level 2.
Phone Number:
Reference Name (please print):
Job Title:
CWB Inspector Registration # (if applicable):
Other inspection related qualification (please specify):
I certify the above information to be true and correct. I understand that any false statements may result in the cancellation of this application and/ or the withdrawal of certification.
Reference Signature (Physical/Digital only) Date^ (MM/DD/YYYY)
Address
Complete this section if you have completed a recognized course as per Form 301.
Name of Institution:
Name of Program:
Date Started: Date Completed:
Attach a copy of the applicable diploma for the above program.
Level 3 Candidates Only CWB Form 450E/20^2 3-
Qualifying Work Experience From: To: MM / YYYY
Company Name Job Title
MM/ YYYY
Phone
Explain your duties related to welding inspection below. This section must be completed. Additional copies of this page may be used for multiple companies / multiple references, if required. All additional experience pages provided must be signed by your reference. Resumés will not be accepted.
TO BE COMPLETED BY REFERENCE
Reference Name (please print):
Job Title: Phone Number:
CWB Inspector Registration # (if applicable):
Other inspection related qualification (please specify):
I certify the above information to be true and correct. I understand that any false statements may result in the cancellation of this application and/or the withdrawal of certification.
Reference Signature (Physical/Digital only) Date^ (MM/DD/YYYY)
Address
Complete this section if you have completed a recognized course as per Form 301.
Name of Institution:
Name of Program:
Date Started: Date Completed:
Attach a copy of the applicable diploma for the above program.
CWB Form 451E-2023-
Special Route Candidates
CONFIRMATION OF PRIOR VISUAL WELDING EXPERIENCE
To be completed by Candidate:
I, , am making application for certification to CSA Name of Candidate W178.2 as a visual welding inspection and wish to apply directly to Level □ 2 □ 3 (select one) based on my previous experience as a practicing visual welding inspector.
I certify that I practiced visual welding inspection at the following employer:
Employer (^) (MM/DD/YY)From (MM/DD/YY)^ To
% of Time conducting Visual Welding Inspection
Direct Supervisor (^) Telephone & EmailDirect Supervisor
□ I certify that the visual welding inspection activities noted above do not include the visual assessment of
weld specimens prior to other non-destructive testing (NDT) methods such as radiography, ultrasonic, or magnetic particle and that I understand that experience as a welder, fitter, welding supervisor, project manager, engineer, or welding instructor is not considered as relevant experience.
Signature of Candidate
To be completed by Current / Previous Employer:
□ I certify that the individual named above did practice the visual welding inspection activities as described
above while employed by the organization named.
Name of Current / Previous Employer Representative
Signature of Current / Previous Employer Representative
Note: If the required years of visual welding inspection experience has been achieved by more than one employer, this form must be completed by each individual employer for which relevant experience is being claimed.
Additional copies of this form can be found on our website at www.cwbgroup.org
DATE MONTH DAY YEAR
DATE MONTH DAY YEAR
CWB Form 450E/20 2 3-
Upon completion, please email this form to: inspector@cwbgroup.org OR fax to 1-905-542-1318.
For drop off / mail in, please forward to the office nearest you:
ONTARIO
CWB Group
8260 Parkhill Drive
Milton, Ontario L9T 5V
Tel: (905) 542-
Toll Free:1-800-844-6790 (In Canada only)
ALBERTA
CWB Group
206 – 19 Avenue, Nisku Industrial Park
Nisku, Alberta T9E 0W
Toll Free: 1-800-844-6790 (In Canada only)
QUEBEC
Groupe CWB
4430 Rue Garand
Laval, QC H7L 5Z
Toll Free: 1-800-844-6790 (In Canada only)
