APPLICATION FOR ASSESSMENT OF QUALIFICATIONS AND COMPETENCIES FOR REGISTRATION AS A REGISTERED PROFESSIONAL ENGINEER OF QUEENSLAND

(The Short Form)

INTRODUCTION A successful assessment of qualifications and competencies is required before lodging an application with the Board of Professional Engineers of Queensland for registration as a Registered Professional Engineer of Queensland (RPEQ). This form is only for use by Members who have recently become CPEng or persons who are registered on NPER.
The Minister for Public Works Housing and Information and Communication Technology (Qld) on 25 June 2008 approved Engineers Australias Assessment Scheme under Part 2 of the Professional Engineers Act 2002.

There is a more complete application form for use by all other members of Engineers Australia and non-members. Engineers Australias Approved Assessment Scheme provides further information to help with your application. Applications for Assessment must be lodged with: RPEQ Applications, Engineers Australia, 11 National Circuit, BARTON, ACT 2600 (or, for rapid assessment, by e-mail to Q_assess@engineersaustralia.org.au. Sending by e-mail directly to an individual may delay processing.) An original, signed application must be lodged, even if processing has been based on an e-mailed form.

1. PERSONAL DETAILS (please PRINT in BLOCK letters) Full Name: Engineers Australia number: 2. CONTACT DETAILS (please tick PREFERRED contact details these will be published on a publicly accessible register of engineers)
Private Address: (tick only if this is your preferred register address)

Business Address: - the normal register address for publication Employer: _______________________________________________ Street: _________________________________________________ City: _____________________ State: _______ PostCode: ______

Street: ________________________________________________________ City: ________________________ State: ______ PostCode: _______

Ph: (0__) ____________Fax: (0___) ____________Mob 04 ________ E-mail: __________________________________________________

Ph: (0__) ____________Fax: (0___) ____________Mob 04 ______________ E-mail ________________________________________________________

3.

AREA OF ENGINEERING FOR REGISTRATION

Aerospace Engineering Chemical Engineering Environmental Engineering Structural Engineering Fire Safety Building Services Engineering Civil Engineering Marine Engineering Naval Architecture Subdivisional Geotechnics

(please tick boxes to indicate areas of engineering for assessment of competencies)

I apply for assessment in the selected area(s) of engineering practice (Appendix A to the Approved Assessment Scheme provides details): Biomedical Engineering Electrical Engineering Mechanical Engineering Petroleum Engineering Management

Information, Telecommunications and Electronic Engineering Pressure Equipment Design Heritage and Conservation

Applicants for assessment in an area of engineering may also request assessment in a specific area of engineering: In-Service Inspection of Amusement Verification Rides and Devices

Note: Members may be asked for additional information if selected areas do not correspond with NPER Areas of Practice or their College Membership.

4.

DECLARATION BY ALL APPLICANTS FOR ASSESSMENT OF QUALIFICATIONS AND COMPETENCIES

In support of my application for assessment of qualifications and competencies for registration as a Registered Professional Engineer of Queensland, I, , declare that the information I have provided in this application form and in any documents submitted with this application form are true and correct in every particular and I have made claims of acquired competencies in good faith. I agree to my contact details as specified in Block 2 above and area(s) of engineering as selected in Block 3 above being published. Signature: .. Date:/../

5 January 2012

Issue 2 Revision 3

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