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Recertification Form USD

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Thermographer Recertification Form

Recertification is intended to apply only to individuals who maintain continued active employment within the field of
thermography and demonstrate efforts to keep abreast of new developments in the field. Certified
thermographers wishing to renew their certification at its current level are required to meet continuing education or
professional contribution requirements during a five (5) year period.

Complete this form only if you are recertifying an existing certification and fulfill all requirements below.

If you wish to renew your certification, but cannot prove continuing employment and professional contribution or
education, you will be required to pass the certification exam at either the end of a course at the Level you wish to
renew, or by attending a certification refresher course if available. Keep in mind you can always extend your certification
validity by being trained and examined into a higher category!.

Do not complete this form if you are extending an existing certification through training and
examination!
…………………………………………………………………………………………………………………………………..

Step 1 – Candidate information Step 2 –Certification level


Student name: .....  Level I
Certification ID number: ..  Level II
Company: .........  Level III
Address: ..... Expiration date:
Phone: ......... Step 3 –Most recent course attendance
Fax: .......... Date: .........
E-mail: ..... Place: .........

Step 4 – Continued Active Employment – Required

The individual named above has proof on file of activity within the field of Thermography totaling a minimum
accumulation of 25% of working hours during the term of his or her existing certification.

Signature: ___________________________________ Name (print or type): ______________


Title: ........... Date: __________________________ ___
Email or direct telephone: ________________

Step 5 – Select one of the following – Required



 I have published or presented a technical paper or case study at a Thermography conference, in a
technical journal or magazine. Submit a copy of the article with this recertification form.
 I have recently written a technical paper or case study. Submit a copy of the article with this
recertification form.
 I have attended a total of 5 half-day (2.5 days total) sessions at a Thermography conference or course.
Submit proof of attendance with this recertification form.

Submit all materials in electronic format AND A DIGITAL PHOTO (jpg) for your new ID card to:

[email protected]

A charge of 350$ for recertification processing will apply

Pub No 1560110_F-en-GB Page 1 of 1

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