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  • Il Iema 254 (3935) 2019

Get Il Iema 254 (3935) 2019-2026

Ormation. Make funds payable to IEMA. Application fees are not refundable. See web site for exam dates/forms: Radtech.iema.illinois.gov If you have any questions, please call us at 217-785-9913. Name - - I. Social Security Number Last II. Sex: Address Birthdate Business Telephone # ( MI First F M / ) Home/Cell Telephone # ( Number & Street / ) Email (Required) City Zip State III. Type of Industrial Radiography for which Certification desired Radioactive Materials Both X-.

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How to fill out the IL IEMA 254 (3935) online

The IL IEMA 254 (3935) form is essential for individuals seeking certification in industrial radiography. This guide provides a clear and supportive approach to completing the form online, ensuring that all required information is accurately submitted.

Follow the steps to complete the IL IEMA 254 (3935) online.

  1. Use the ‘Get Form’ button to access the IL IEMA 254 (3935) form and open it in your online editor.
  2. Begin by entering your personal information in the designated fields. This includes your name, social security number, sex, address, business telephone number, home/cell telephone number, and email address. Ensure that all information is legible and accurately filled out.
  3. In Section III, select the type of industrial radiography for which you are seeking certification. You can choose from radioactive materials, x-ray, or both.
  4. In Section IV, specify the type of certification required. Options include initial certification, certification as an industrial radiographer trainee, certification by reciprocity, or re-certification. Remember to attach any necessary documentation as required.
  5. If you are applying for initial certification, complete Section V by providing documentation of your minimal work experience. Ensure an authorized individual signs this section to validate your work experience.
  6. In Section VI, indicate your current employment status. If currently employed, provide the name of your employer and their address. If unemployed, select the appropriate option.
  7. Answer the attestation questions in Section VII honestly, providing explanations on a separate sheet if you answer 'yes' to any of the questions.
  8. Review the agreement in Section VIII and confirm your compliance with all rules and regulations by signing the application.
  9. In Section IX, certify that your child support obligations are met by signing and dating the application.
  10. Before submitting, review your application to ensure that all questions are answered, the application is signed, and the fee of $125 is enclosed. Ensure you have included any required supporting documentation.
  11. Finalize your submission by saving any changes, downloading a copy for your records, printing the form, or sharing it as necessary. Send the application to the provided address.

Start filling out your IL IEMA 254 (3935) form online today to ensure a smooth certification process.

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