Get Form D5 Examinee Application Form - American Concrete Institute - Concrete

This guide provides detailed instructions on how to complete the FORM D5 Examinee Application Form for the American Concrete Institute's Concrete Transportation Construction Inspector certification. By following these steps, users will be able to confidently fill out the form online and ensure all necessary information is included.

Follow the steps to successfully complete your application form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Section A must be completed by the applicant. Start by providing your full name, Social Security number, and contact information including your address, city, state, and zip code.
3. Next, indicate your present employer's information along with their phone number. If you are certified as an ACI Concrete Construction Special Inspector, attach a copy of your wallet card or certificate. If not, be prepared to submit full documentation of your education and work experience as outlined in the Inspector Workbook.
4. Complete your educational background by listing the name of the institution, its location, the degree received or credit hours earned, and the dates you attended. Attach a copy of your diploma or transcript as required.
5. Move on to Section B. Here, provide the employer's name during the relevant time period, along with the respondent's name and their address. Specify your title during that time and the duration of your working relationship using the month and year format.
6. Indicate the percentage of your total employment time spent on concrete inspection work. Remember that 100% means you worked strictly in this capacity, while less reflects a combination of responsibilities.
7. Detail the percentage of your time dedicated to various areas of concrete inspection, ensuring the total equals the percentage noted previously.
8. Answer the questions about your work experience related to decision-making responsibilities, verification of compliance, and documentation of results. Ensure you check the appropriate responses.
9. Sign and date the application to confirm your authorization for references to provide information about your work experience. Be aware that inaccuracies may result in denial of certification.
10. Finally, return the completed form to the respondent who will fill in Section C. Ensure they review and verify all information provided before returning the form in a sealed envelope.
11. After completing the form, you can save your changes, download a copy, print it for your records, or share it as needed.

Complete your FORM D5 application online today to start your certification process.