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NB-120-2, Rev.

1, (05/20/14)

National Board of Boiler and Pressure Vessel Inspectors


Application for the New Construction Commission: A /AR Endorsement
APPLICATION INSTRUCTIONS
1. This application is a writable PDF. Please download the application document and save it on your computer. You can then open the
application, type in your information, and print the application form. (Any application filled in while viewing it online will not be
saved.) All applications must be typed and may ,be emailed, faxed, or mailed to the National Board.
2. The completion of this application requires the joint effort of the applicant and the applicants employer. Fill out all pages of this
application completely. Use additional pages, if necessary.
3. Please enter the applicants name as it appears on the applicants passport/government-issued ID/drivers license.
4. Be sure to include a unique and current email address for both the applicant and the applicants employer. All National Board
correspondence will be sent to the applicants employers email address, unless directed otherwise.
5. Be sure to keep a copy of the completed application that you submit to the National Board, including copies of diplomas, certificates of
courses completed, etc.
6. When you have completed your application, see checklist at the back of this packet to ensure you have included all the information and
documents necessary.

LISTED BELOW ARE ABBREVIATIONS THAT MAY BE USED IN THIS APPLICATION:


ASME BPVC: American Society of Mechanical Engineers, Boiler and Pressure Vessel Code
ASNT: American Society for Nondestructive Testing
NBIC: National Board Inspection Code

This form may be obtained from The National Board of Boiler and Pressure Vessel Inspectors 1055 Crupper Avenue, Columbus, Ohio 43229-1183

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NB-120-2, Rev. 1, (05/20/14)

Application for the National Board


New Construction Commission: A /AR Endorsement
A AR

GENERAL INFORMATION
APPLICANT NAME:

(First)

(Middle)

(Last)

(Applicant City)

(Applicant State or Province)

(Applicant Postal Code)

(Applicant Street Address)

(Applicant Country) (Applicant Citizenship)

(Applicant Telephone)

(Initials)

(Applicant Email)

(Applicant Date of Birth) mm/dd/yr

I understand that all information provided on this application is subject to verification by the National Board.

If the applicant holds a National Board Commission, please enter the commission number:

EMPLOYMENT
The applicant for a New Construction Commission: (A) Endorsement must be employed by an Authorized Inspection Agency, as defined in
NB-263, or the National Board.
PRESENT EMPLOYER:
(Employer Street Address)

(Employer City)

(Employer State or Province)

(Employer Postal Code)

(Employer Country) (Employer Contact Name)

(Employer Contact Telephone) (Employer Contact Email)

EXAMINATION FOR NEW CONSTRUCTION: (A) ENDORSEMENT


The applicant must satisfactorily complete the National Board New Construction Commission and Authorized Inspector Course (A).
(A) COURSE DATE

EXAM DATE

EXAM LOCATION

This form may be obtained from The National Board of Boiler and Pressure Vessel Inspectors 1055 Crupper Avenue, Columbus, Ohio 43229-1183

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NB-120-2, Rev. 1, (05/20/14)

ON-THE-JOB TRAINING FOR NEW CONSTRUCTION: (A) ENDORSEMENT


The applicant for the New Construction: (A) Endorsement must have a minimum of 80 hours of on-the-job training in ASME BPVC Section I, IV,
or VIII shops. Please complete the information requested.
AUTHORIZED INSPECTION AGENCY

AUTHORIZED INSPECTION SUPERVISOR


NAME AND ADDRESS OF MANUFACTURER
(Manufacturer Name) (Date Assignment Began) (Date Assignment Ended)

(Manufacturer Street Address)

(Manufacturer City)

(Manufacturer State or Province)

(Manufacturer Postal Code)

(Manufacturer Country) (Manufacturer Contact Name)

(Manufacturer Contact Telephone)

(Manufacturer Contact Email)

Job Responsibilities (Detailed Description)

EXAMINATION FOR: (AR) ENDORSEMENT


The applicant must complete the National Board Inspection Code, Part 3, Repairs and Alterations online course and pass the associated
examination.
COURSE COMPLETION DATE

EXAMINATION DATE

EDUCATION AND EXPERIENCE


The applicant must have a minimum of five (5) credit points accumulated under Education (and Training) and Experience, as described in this
application.

This form may be obtained from The National Board of Boiler and Pressure Vessel Inspectors 1055 Crupper Avenue, Columbus, Ohio 43229-1183

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NB-120-2, Rev. 1, (05/20/14)

APPLICANT/EMPLOYER CERTIFICATION

On behalf of the employer, I hereby certify the applicant has met the requirements as stated herein, and is in our regular employ.
EMPLOYER REPRESENTATIVE AND TITLE (PLEASE PRINT):
(Employer Representative Signature) (Month / Day / Year)

By the signature below, the applicant certifies that the information herein is correct and further agrees to abide by NB-263, Rules for National
Board Inservice and New Construction Commissioned Inspectors and all other standards applicable to the National Board Commission.
(Applicant Signature) (Month / Day / Year)

EDUCATION AND TRAINING


For education and training, the applicant must have a minimum of one (1) credit point and may receive a maximum of four (4) credits point.
Please attach a copy of your high school diploma or certification and a copy of each training course certificate, technical curriculum
certificate, or college/university diploma used for credit points.
1. High School or Equivalent, Required for All Applicants:
The applicant must have a high school education (12 years or equivalent educational system). The intent of this requirement is to ensure
an applicant has the necessary basic skills in reading, writing, and mathematics to successfully complete the duties of an inspector. In
countries outside the US, the high school or equivalent educational system may differ from that in the US.
Please complete the information requested for education received:
(High School Name) (Location) (Date Completed)

(Describe Equivalent Education System)

2. The following types of technical training in boiler & pressure vessel inspection courses have a value of one (1) credit point.
One (1) credit point maximum is allowed for this category:
Completion of a course in at least one (1) of the following (or related) subjects: quality systems, engineering, fabrication methods,
nondestructive examination, or inspection.
(Course Name) (Location) (Date Attended)

Completion of a course on knowledge, understanding, and general structure of the National Board Inspection Code (NBIC) Part 1, 2, or 3
or other codes or related standards, such as the ASME Code or other international code of construction.
(Course Name) (Location) (Date Attended)

Completion of a National Board conducted course on basic inspection methods, data reports, welding, or other related courses.

(Course Name) (Location) (Date Attended)

This form may be obtained from The National Board of Boiler and Pressure Vessel Inspectors 1055 Crupper Avenue, Columbus, Ohio 43229-1183

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NB-120-2, Rev. 1, (05/20/14)

3. The following types of technical curriculum have a value of two (2) credit points.
Two (2) credit points maximum are allowed for this category:
Graduation from an accredited Technical School (in construction, engineering, or any other technology related to inspection)
(Name of School) (Major Field of Study) (Year Graduated)

Completion of a Power Engineering Certification Program

(Issued By) (Date)

Completion of an Accredited Trade Certification Program in such skills as a boilermaker, industrial machinery mechanic, steam fitter,
machinist, millwright, or welder
(Issued By) (Title) (Date)

Completion of a military or merchant marine training program in the area of marine or stationary boilers or pressure vessels
(Course Name) (Institution) (Date Completed)

Completion of a Certified Welding Inspector (CWI) Certification Program from the American Welding Society or an equivalent certification

(Title of Certification) (Date Issued)

4. The following college/university studies have a value of three (3) credit points.
Three (3) credit points maximum are allowed for this category:
Associates degree in science, mathematics, or engineering
(School Name) (Major)

(Dates Attended) (Degree Type)

Bachelors degree in science or mathematics


(School Name) (Major)

(Dates Attended) (Degree Type)

5. The following college/university studies have a value of four (4) credit points.
Bachelors degree in engineering
(School Name) (Major)

(Dates Attended) (Degree Type)

This form may be obtained from The National Board of Boiler and Pressure Vessel Inspectors 1055 Crupper Avenue, Columbus, Ohio 43229-1183

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NB-120-2, Rev. 1, (05/20/14)

EXPERIENCE
For experience, the applicant must have a minimum of one (1) credit point and may receive a maximum of four (4) credit points.
One (1) credit point may be assigned for each full years technical experience associated with boilers and pressure vessels in the categories
listed below. Credit for concurrent experience in two or more categories is not permitted.
Please check the items used for credit:
Engineering design review, or manufacturing, including fabrication methods or processes in either shop or field, or responsibility for the
operation of boilers exceeding 50,000 lbs. of steam per hour total capacity.
(Employer Name) (Date Assignment Began) (Date Assignment Ended)

(Employer Street Address)

(Employer City)

(Employer State or Province)

(Employer Postal Code)

(Employer Country) (Employer Contact Name)

(Employer Contact Telephone) (Employer Contact Email)

Job Responsibilities (Detailed Description)

Responsibility for the performance of repairs, alterations, or maintenance of boilers or pressure vessels, or involvement with quality
control systems related to boiler or pressure vessel manufacturing, repair, or alteration in either shop or field, or responsibility for
inspection of boilers or pressure vessels either inservice or during construction, including shop or field, or experience as an ASNT Level II
or III (qualified by examination) examiner of boiler and pressure vessels or experience holding equivalent qualifications
(Employer Name) (Date Assignment Began) (Date Assignment Ended)

(Employer Street Address)

(Employer City)

(Employer State or Province)

(Employer Postal Code)

(Employer Country) (Employer Contact Name)

(Employer Contact Telephone) (Employer Contact Email)

Job Responsibilities (Detailed Description)

This form may be obtained from The National Board of Boiler and Pressure Vessel Inspectors 1055 Crupper Avenue, Columbus, Ohio 43229-1183

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NB-120-2, Rev. 1, (05/20/14)

CHECKLIST
1. All pages of the application completed
2. All copies of diplomas or certificates attached, if required
3. Copy of completed application made for the applicants records

SUBMIT APPLICATION TO:


Email: jbock@nationalboard.org
Fax: 1.614.847.1828
Mail:


The National Board of Boiler and Pressure Vessel Inspectors


Attention: Jeanne Bock
1055 Crupper Avenue
Columbus, OH 43229-1183

Questions: Contact Jeanne Bock: jbock@nationalboard.org

PRINT

This form may be obtained from The National Board of Boiler and Pressure Vessel Inspectors 1055 Crupper Avenue, Columbus, Ohio 43229-1183

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