Wens Technical & Occupational Skills Training LLC
Course & Examination Enrolment Form (BINDT-PCN)
[email protected]
Enrolment Details Email
Course Only x Course & Examination
Current Employer
Course / Exam Venue: -
TCR ARABIA COMPANY LIMITED
x Dubai Others (Specify)________________ Organization Name
GAS Gardens, King Abdulaziz Seaport Facility
Course Ref __________________________________ Address
Course Title Ultrasonic Testing Level 1/2 (welds) 3.1 3.2
________________________________ Dammam
City State/Prov.
Course Date _________________________________ 32211 Saudi Arabia
ZIP/Postal Code Country
Examination only 00966-13-8475784
Resit Phone Fax
[email protected]
Previous PCN Result Notice #___________________ Email
Recertification Supplementary Send PCN Result Notice to
Pervious Cert No______________________________
To Candidate’s Address x To Current Employer
Expiry Date- _______________________________ To Test centre
Preferred Exam Date __________________________
Pre-Certification Experience
Self-Sponsored Company Sponsored
Claimed duration of experience in applying The NDT
Examination Applied For method under qualified supervision (months or weeks)
71 months
NDT Method (Select One)
x UT Name, address and telephone number or Email
RT PT MT VT WI
address of person who can verify experienceclaimed:-
BRS RPS
[email protected] [email protected] [email protected]Products or industry sector in which certification is
sought Notes
1. Experience is not an essential pre-requisite for
Casting Wrought products and forgings examination; however certification will not be
awarded until required experience is attained.
x Welds Pre & In-service inspection, Please Contact WENS for more clarification.
2. Experience satisfying the requirements detailed in
NDT Level PCN/GEN at clause 6.4 may be gained following
examination and recorded on Form PSL/30.
Level 1 x Level 2 Level 3 3. Once evidence of experience satisfying PCN/GEN
clause 6.4.1 or 6.4.2 is accumulated, it is provided
Candidate Details direct to BINDT together with an application for
certification using form PSL/57C
PCN Identification Number :
(For Existing PCN Certificate Holders) Pre-Certification Training (Applicable forInitial
Candidates who enrol for examination only)
Last Name (Surname) First Name (Given Name) Name of training organisationand title/reference of
relevant training course :
Candidate’s Date of Birth Passport/ NID / SS Number
___________________________________________
Usual Residential Address
Dates of Course: ____________________________
City State/Prov.
Please attach evidence of satisfactory completion of
Postal Code Country PCN approved training course. Form PSL/42 may
optionally be used to record additional on-the-job
Phone Fax training (Refer PCN/GEN clause 6.2.4).
QF-002-03 – Application Form (BINDT-PCN) Date: 31/3/2016
Wens Technical & Occupational Skills Training LLC
Course & Examination Enrolment Form (BINDT-PCN)
Card Holder’s Signature
Candidate’s statement confirming eligibility for Card Holders Address (Same as billing addresses)
examination
RONEL JOHN R. CUSTODIO Address
Candidate’s full name
City State/Prov.
PCN number (For existing PCN certificate holder): ZIP/Postal Code Country
I have read and understand PCN General Phone Fax
Requirements for the certification of personnel engaged
*Credit Card Identification Number: Visa/MasterCard The three-digit
in NDT, particularly the criteria for eligibility, and hereby number is printed on the signature panel on the back of the card
confirm that I satisfy those criteria covering vision, following the account number. American Express: The four-digit
training and experience applicable to the level and NDT number is printed above the account number on the front of the card.
method for which I am seeking certification. In the event
I should be awarded PCN certification. I agree to comply Company Invoice - Attach Company Order
with the PCN Code of Ethics (published as PCN
document CP/27). Wire transfer(Please Add Dhs 50 or equivalent for
I understand that, in the event of a false statement being administrative and bankcharges)
discovered, any certification awarded as a result of the
examination will be null and void. I accept responsibility Wire Transfer details
for payment of examination fees in the event of non-
payment by the sponsor. Bank Name :
May 27, 2021 Account Number :
Signature Date
SWIFT code :
Verification of candidate’s statement by the
sponsorer, employer, or a referee if the candidate is Terms and Conditions
self-employed.
All the payment should be paid before closing date,
To the best of my belief, the candidate's statement given including payment against Invoice
above is correct at the time of signing. Cancellation before closing date, 50 % fee refund
SENTHIL PERIYASAMY Rescheduling before closing date service charge Dhs
Name
500
No refund after closing date
Signature
No refund for No show
TCR ARABIA COMPANY LIMITED
All request in writing-Fax-email
Company Name
[email protected] Check List
Telephone Email
Payment Details 1. All sections of the Form Complete and signed
2. Vision Test Certificate (PCN PSL/44 may be used)
Calculated fees ( In Dhs) ________________________ 3. Evidence of experience (PCN PSL/30 may be used)
Check /Draft make payable Wens Technical & 4. Evidence of training (PCNPSL/42 may be used)
Occupational Skills Training LLC
5. Payment -Correct examination fee
Personal Credit Card Company Credit Card.
For any clarifications or for any local assistance do call
Visa Card MasterCard Amex or email with details.
Holder Name Receipt and acknowledgment of this completed
application form will be sent within 4 working days.
Card Number
Expiry Date CIN Number*
QF-002-03 – Application Form (BINDT-PCN) Date: 31/3/2016
