API CPD Activities Form
For activities where documentation is not readily available
Certificant Information
Name (as displayed in the ICP Portal): API ID:
Check Certifications List Certification Numbers
API 510
API 570
API 653
Activity Information
Activity Date(s): Activity Duration (hours):
Activity Name: Location:
Check role:
Participant Presenter/trainer Other (explain):
Description of Activity, the knowledge you acquired (ex. NDE, Welding inspection, Damage
Mechanisms) and applicability to certification(s):
Website link for event (if applicable):
Verification of Attendance
____________________________________
Printed Name __________________________________________
Position: Signature
Company: Date Signed:
*For attendees, the leader of the meeting, host, trainer or supervisor may sign off
For trainers/presenters, the host or trainer’s supervisor may sign off