BGAS Sample Form

Please mark here if you are Self- Sponsored

Plea Pl easemark here if you are Company Sponsored

Plea Pl easewrite wri te beginning Date of your course according to Gregorian Calendar Do not Write any thing in this box.

For BGAS CSWI P G.3/2 G.3/2 For BGAS CSWIP G.1 For BGAS BGA S CSWI P Site Coating For CSWI P Cathodic Cathodic Prote Pr otection ction For CSWIP Plant I nspection L.I Paint 3/2 3/2 Paint G.1 CP Coating PL ANT

ATC88 AT C88 ATC89 AT C90 AT C37 PL1

BGA S CSWI CSW I P Painting I nspe nspection G. 3/2 BGA S CSWI CSW I P Painting I nspe nspection G. 1 Cathodic Cathodic Prote Pr otection ction L evel I ,II &I I I BGA S CSWI CSW I P Site Coatings I nspe nspecto ctorr CSWI P Plant Plant I nspe nspection tion L .I

Ple Pl ease ase Use Only Capital C apital Le L etters tters for Wri W riting ting Your F irst ir st and Last L ast Name. Plea Pl easewrite wri te your your nameaccording ordi ng to its spelling spelli ng in your passport.

 Y ou don’t don’t need to write in these sections

Write Wr ite Your Y our Bir th Dateonly According rdi ng to Gre Gr egori gorian an Calendar

Please write your Address with Postal code, call number, cell phone number and email addr ess.

Please writ write e another addres addr ess her e. I f you haven’t another address address please please write: wri te: As Abov A bove e.

Cautation

:

I f you are sponser ed by a Company you should hould fill fil l this section Sign Here

Wr ite Y our Compan Company y Address Here

Who is incharge in your registration or your payment, write his/her information in this section. I f you are ar e selflf - Sponcer Sponcer ed only write : S.E or Self- Sponcered

I f you are a WJ W J S member or you are an employee of an I ndustrial ndustri al member of T WI please tick here

I f you have have a disability disabili ty please M ark here.

Choos Ch oose your cour se venue

If it is the first time that you takethis exam write Initial. If you are retested please write retest

Please write only BGAS here

Write information of your company activity here

If you have any certificateabout under water Inspection, Plant Inspection or plastic welding please circle its name and attach a copy of your certificate(s) to this form.

 Y ou don’t need to write in these sections

If you have any BGAS or CSWIP certificate Please write your BGAS or CSWIP number here If you have any NDT certificate please cercle name of it and attach a copy of your certificate(s) to this form.

 This page is for NDT and Welding Inspection courses. Don’t write any thing here

This part is for Plant Inspection course. Don’t write any thing here

Your Signature