Former Member (more than 6 months lapse in membership):
Yes, Member # No
Last Name First Name M.I. Mr./Ms.
Home Address
City State Zip/Postal Code
Country Phone Fax
Cell Phone Home E-mail Birth Date (MM/DD/YYYY)
Company Name
Company Address
City State Zip/Postal Code
Country Business Phone Business Fax
Business E-mail
Member Information
ASNT Individual Membership Application
Send Materials to: Home Office
Did you learn about ASNT through a member? Yes No
If “Yes”, member’s name: ________________Member’s # (if known)_____
Local Section (Chapter) Choice
Choices posted online at www.asnt.org
Complete both sides of this form and mail or fax to:
ASNT, PO Box 28518, Columbus, OH USA 43228–0518
Fax 614.274.6899.
Join online at www.asnt.org.
For Questions Contact:
Phone 614.274.6003
Toll Free 800.222.2768 (US/Canada)
Please complete both sides of this form.
Membership Profile
Highest Educational Level
Grades 1–12
High School Diploma
Some College
2-Year Associate Degree
4-Year Undergraduate Degree
Master’s Degree
Doctorate Degree
Your Job Function—Choose the one which best describes
your role. (select only one)
NDT Management Sales/Marketing
Quality Management Researcher
Engineer Academic/Educator
Technician/Inspector Trainer/Instructor
Consultant Student
Gender Male Female
Year of Birth
Years of Experience in NDT
0–5 6–10 11–15 16–20 21 & over
Number of people involved with NDT at your company
1–5 6–20 21–50 51–100 over 100
Purchasing Responsibility (select all that apply)
I recommend/approve purchase of
equipment/instruments/supplies
I recommend/approve purchase of training & study
materials/programs
I recommend purchase of services
I am not involved in purchasing
With which NDT method(s) do you work? (select all that apply)
Acoustic Emission Liquid Penetrant
Alternating Current Magnetic Flux Leakage
Field Measurement Magnetic Particle
Electromagnetic/Eddy Current Neutron Radiography
Ground Penetrating Radar Radiography
Infrared & Thermal Ultrasonics
Laser Vibration Analysis
Leak Visual
Source Code WEB
1.
2.
3.
4.
5.
6.
7.
8.
Last Name First Name
With Airmail
Service Included
Dues with Airmail
Service Included
One-Year
Two-Year
Three-Year
Five-Year
Student, One-Year Must submit transcript or letter of enrollment
Military Rank E-5 or lower
$75 $123
$135 $219
$190 $304
$300 $475
$15 $63
$30 $78
Membership Options
Return with payment to The American Society for Nondestructive Testing, Inc., PO Box 28518, Columbus OH 43228-0518;
Or join online at www.asnt.org, Fax 614.274.6899, Phone 614.274.6003 or 800.222.2768 US/Canada. Federal ID# 31-1231529.
Payment Information Total Amount Paid $
AmEx MasterCard Visa Discover Form of Payment Check Funds Transfer
Type of Card
Account Number
Name on Card Print please
Signature
Cardholder Information
Personal Business
Exp. Date
Address, City, State, Zip, Country
CIN*
* Credit Card Identification Number. For Visa/MasterCard/Discover: The three-digit value is printed on the signature panel on the back of cards immediately
following the account number. For American Express: 4 digit, non-embossed number printed above your account number on the face of your card.
Research in Nondestructive Evaluation (RNDE®) Individual Subscription
RNDE® is ASNT’s quarterly research journal.
Print Subscription — for current volume
Electronic Subscription — for current volume
Print and Electronic Subscription —a savings of $35
$55 $129
$55
$75 $149
All pricing subject to change.
Dues are nonrefundable,
nontransferable. Includes
subscription to Materials
Evaluation and The NDT
Technician, a quarterly
newsletter.
For members outside
North America: Unless airmail
is specified, all materials will be
sent sea/surface mail; allow 3-4
months for delivery.
Do not miss out on subscribing
to ASNT’s quarterly research
journal, RNDE.
Dues
Choose the one business industry segment that best
describes your company. (select only one)
NDT Utilization Business
Aerospace/Aviation/Aircraft Medical
Amusement Rides & Skiing Nuclear
Automotive Optical
Chemical & Petroleum Ordnance
Construction Pipeline
Commercial Labs Pulp/Paper
Infrastructure (Roads & Bridges) Railroad
Electronics Semi Conductor
Marine Utilities
NDT Supplier Business
Consulting Robotics
Distributor/Manufacturers’ Supplies
Representative Training
Equipment Computer Software
Research Computer Hardware
Choose the primary type of application of NDT that you do?
(select only one)
Design and Failure Analysis
Field Inspection
Incoming Inspection
In-service, Plant/Operation Maintenance & Process Control
Product Life Extension
QA/QC Reliability
None of the above
Highest Level of NDT qualification. (select only one)
None ASNT NDT Level III
Level I ACCP Level II
Level II ACCP Level III
Level III IRRSP
Other_____________________________________
Membership Profile continued
9. 10.
11.
All payments including checks and money orders must be made in U.S. funds (dollars) through U.S. Banks.
Yes, Member # No
Last Name First Name M.I. Mr./Ms.
Home Address
City State Zip/Postal Code
Country Phone Fax
Cell Phone Home E-mail Birth Date (MM/DD/YYYY)
Company Name
Company Address
City State Zip/Postal Code
Country Business Phone Business Fax
Business E-mail
Member Information
ASNT Individual Membership Application
Send Materials to: Home Office
Did you learn about ASNT through a member? Yes No
If “Yes”, member’s name: ________________Member’s # (if known)_____
Local Section (Chapter) Choice
Choices posted online at www.asnt.org
Complete both sides of this form and mail or fax to:
ASNT, PO Box 28518, Columbus, OH USA 43228–0518
Fax 614.274.6899.
Join online at www.asnt.org.
For Questions Contact:
Phone 614.274.6003
Toll Free 800.222.2768 (US/Canada)
Please complete both sides of this form.
Membership Profile
Highest Educational Level
Grades 1–12
High School Diploma
Some College
2-Year Associate Degree
4-Year Undergraduate Degree
Master’s Degree
Doctorate Degree
Your Job Function—Choose the one which best describes
your role. (select only one)
NDT Management Sales/Marketing
Quality Management Researcher
Engineer Academic/Educator
Technician/Inspector Trainer/Instructor
Consultant Student
Gender Male Female
Year of Birth
Years of Experience in NDT
0–5 6–10 11–15 16–20 21 & over
Number of people involved with NDT at your company
1–5 6–20 21–50 51–100 over 100
Purchasing Responsibility (select all that apply)
I recommend/approve purchase of
equipment/instruments/supplies
I recommend/approve purchase of training & study
materials/programs
I recommend purchase of services
I am not involved in purchasing
With which NDT method(s) do you work? (select all that apply)
Acoustic Emission Liquid Penetrant
Alternating Current Magnetic Flux Leakage
Field Measurement Magnetic Particle
Electromagnetic/Eddy Current Neutron Radiography
Ground Penetrating Radar Radiography
Infrared & Thermal Ultrasonics
Laser Vibration Analysis
Leak Visual
Source Code WEB
1.
2.
3.
4.
5.
6.
7.
8.
Last Name First Name
With Airmail
Service Included
Dues with Airmail
Service Included
One-Year
Two-Year
Three-Year
Five-Year
Student, One-Year Must submit transcript or letter of enrollment
Military Rank E-5 or lower
$75 $123
$135 $219
$190 $304
$300 $475
$15 $63
$30 $78
Membership Options
Return with payment to The American Society for Nondestructive Testing, Inc., PO Box 28518, Columbus OH 43228-0518;
Or join online at www.asnt.org, Fax 614.274.6899, Phone 614.274.6003 or 800.222.2768 US/Canada. Federal ID# 31-1231529.
Payment Information Total Amount Paid $
AmEx MasterCard Visa Discover Form of Payment Check Funds Transfer
Type of Card
Account Number
Name on Card Print please
Signature
Cardholder Information
Personal Business
Exp. Date
Address, City, State, Zip, Country
CIN*
* Credit Card Identification Number. For Visa/MasterCard/Discover: The three-digit value is printed on the signature panel on the back of cards immediately
following the account number. For American Express: 4 digit, non-embossed number printed above your account number on the face of your card.
Research in Nondestructive Evaluation (RNDE®) Individual Subscription
RNDE® is ASNT’s quarterly research journal.
Print Subscription — for current volume
Electronic Subscription — for current volume
Print and Electronic Subscription —a savings of $35
$55 $129
$55
$75 $149
All pricing subject to change.
Dues are nonrefundable,
nontransferable. Includes
subscription to Materials
Evaluation and The NDT
Technician, a quarterly
newsletter.
For members outside
North America: Unless airmail
is specified, all materials will be
sent sea/surface mail; allow 3-4
months for delivery.
Do not miss out on subscribing
to ASNT’s quarterly research
journal, RNDE.
Dues
Choose the one business industry segment that best
describes your company. (select only one)
NDT Utilization Business
Aerospace/Aviation/Aircraft Medical
Amusement Rides & Skiing Nuclear
Automotive Optical
Chemical & Petroleum Ordnance
Construction Pipeline
Commercial Labs Pulp/Paper
Infrastructure (Roads & Bridges) Railroad
Electronics Semi Conductor
Marine Utilities
NDT Supplier Business
Consulting Robotics
Distributor/Manufacturers’ Supplies
Representative Training
Equipment Computer Software
Research Computer Hardware
Choose the primary type of application of NDT that you do?
(select only one)
Design and Failure Analysis
Field Inspection
Incoming Inspection
In-service, Plant/Operation Maintenance & Process Control
Product Life Extension
QA/QC Reliability
None of the above
Highest Level of NDT qualification. (select only one)
None ASNT NDT Level III
Level I ACCP Level II
Level II ACCP Level III
Level III IRRSP
Other_____________________________________
Membership Profile continued
9. 10.
11.
All payments including checks and money orders must be made in U.S. funds (dollars) through U.S. Banks.
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