Welding Certification Interest Form

The following is for Local 104 members in good standing. If you are not a Local 104 member, you are not eligible to proceed.

Complete and submit this form if you are interested in obtaining a weld certification. Upon review of your form, we will contact you to schedule a certification date or to recommend additional training.

Personal Information

Name(Required)

First Last

Date of Birth(Required)

Phone(Required)

Email(Required)

Experience and Background

Are you currently employed?(Required)

Yes

Current Occupation/Job Title(Required)

Years of Experience in Welding(Required)

Have you completed any formal training in welding?(Required)

Yes

If yes, specify training (e.g., courses, certifications, institutions)(Required)

Certification Details

What welding process would you like to certify with?(Required)

What position would you like to certify in? (e.g., Flat, Horizontal, Vertical, Overhead):

Have you been previously certified in this process?

If so, what was the date of your previous certification?

Is this certification at the request of your employer?

What base metal material is required?

What base metal thickness is required?

Are you planning to use this certification for employment, personal skill development, or other reasons? (Specify):