PE Rev- 13

(For office use)

The Institution of Engineers ( India)

8, GOKHALE ROAD, KOLKATA 700 020
Paste latest
APPLICATION FOR PROFESSIONAL ENGINEER Photograph
(FRESH/RENEWAL)
PART I
(To be filled by the applicant in his/her handwriting using black ink only)
(Please refer to the ‘Guidelines for Applicants’ before filling up the form)

1. Name in block letters: First Middle Last

Son/Daughter/Wife of

Address in block letters

City in block letters Pin

State in block letters

E-mail id: …...................................................................……………. Tele No (........….)...............…………….

D D M M Y YY Y Mobile No...............................................
Date of Birth:
Each item to be signed
by at least one
Nationality: nominator after
personal verification
2. Academic Qualifications:
BE / B. Tech or Equivalent Discipline University Year of Passing

ME / M Tech or Equivalent Discipline/Specialisation University Year of Passing

Ph D or Equivalent Discipline/Subject University Year of Passing

Any other non-engineering Post Graduation professional qualifications:

...........................................................................................................................................................................
...........................................................................................................................................................................
Field of specialisation in engineering, if any: -
………………………………………………………………………………………………….......................
Enclose attested photocopies of each of the above certificates

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3.Name & Category of membership of engineering related professional institution(s). Each nominator
has to sign one
(a).................................................................................................................................... item after due
(b)................................................................................................................................... verification.

(c)....................................................................................................................................
(d)....................................................................................................................................
4.Record of engineering experience since graduation in chronological order. (Ref. item 4.1 of Guidelines)
Dates Employer/Client Job Title Major job responsibilities
(if self employed/consultant)

5. Professional Development Programme(s)/Activities for last five years, starting from current year.
5.1 Recognised Training Programme(s), Conferences, Seminars, Workshops, Technical Presentations
attended /participated.
Conducting
Sl. No. Title/Subject Duration & Dates Nature of Participation
Organisation
1.

2.

3.

4.

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 Each nominator is
expected to sign at
least one item after
due verification.

5.2 Books/Articles/Research/Technical Reports written by applicant

Title Date of Finalisation Published by/Submitted to

5.3 Professional contributions in emergency works (e.g. Flood Relief, Earthquake, Fire Fighting etc.)
Enclose supporting documents for Sl No. 5.
6. Discipline of Professional Engineer applied for:

Civil Electrical

Chemical Mining

Mechanical Electonics &

Telecommunication

Textile

7. Assessment Examination, if applicable (Ref. Item 6 of Guidelines) Yes No

7.1 Choice of Examination Centre Code
7.2 Discipline Specialisation (wherever available)
(Please see ‘Assessment Examination’ in www.ieindia.org for the available specialisations in
Module 2 (Part II) and choice of Examination Centre)

7.3 Examination fee Rs.4000/- or US$ 400 (for applicants other than citizen of India & Nepal) to be
given by Demand Draft

(An additional fee of Rs.3000 towards interview by electronic media will be required to pay by the applicant
after successful completion of PE online assessment examination)

8. For Renewal of PE Certification Yes No

Rs. 3000/- or US$ 300 (for applicants other than citizen of India & Nepal) to be paid towards the fee for renewal
of PE Certification with an additional amount of Rs.3000/- towards the fee for appearing in the interview
through electronic media.

[N.B.: - For upgradation from PE (India) to IntPE (India) a separate application form is required to be
filled up, which is available in the website, the applicable fee for upgradation to IntPE (I) register is
Rs.10, 000/- or US$ 500 (for applicants other than citizen of India & Nepal).]

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 9. Self-appraisal for certification as Professional Engineer (Refer item 4/6.5(a) of Guidelines as
applicable) (Attach separate sheet)
10. Declaration:
_ I wish to be certified as Professional Engineer in discipline as mentioned in the
application form.
_ I agree to abide by the Code of Ethics established for Professional Engineers and to
be held individually accountable for my actions.
_ I have no objection against my certification process being stopped, should there be
any inaccuracy in the submitted information.
_ I have no objection against my certificate being terminated after certification
according to prevailing rules on the date of termination as Professional Engineer.
_ I agree that the decision on Certification and Termination shall be binding on me.
_ I hereby swear that the contents of the items described in this application documents
are true and correct.
Date :
Applicant’s Signature ........................................

Applicant’s Name ..............................................

Nos.
Enclosures : 1. Qualification Certificate
2. Professional Development
Programmes’ Certificate (s)
3. Bank Draft/Credit Card Rs. DD No.
Authorisation
4. Others
Nominations : From personal knowledge of the applicant and in consideration of his/her qualifications as stated in the form,
we recommend him/her as being in every way a fit and proper person to be certified as Professional Engineer.
(Not required for renewal applications.) (Ref. Item 5 of Guidelines)

Name Membership No., Grade & Signature

Name of recognised professional Institution
1.
2
3.

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 Continuous Professional Development Annexure - I
CPD Weight
Classification Applicable CPD Applicable Credit Hours
Type Factor Remarks
Program Hours Obtained
(Multiplier)

Doctorate 2
30
_____________ __________ All achievement
Formal Education
Post shall be supported
Upgrade
Graduate Degree 2 with records and
In Engineering/ (1) 25
___________________ __________ certificates.
Management duly
_________
recognized by BFC (Upper
Limit for total of all =
limit)
Post Graduate Diploma 60 hrs for 5 years
2 20
___________________ __________
_________
Post Graduate
Correspondence/ online 1
20
course (including those
gained through the __________ All achievements
Formal Education internet) shall be supported
Upgrade in Engineering/ ___________________ with records and
Management duly (2) _________ certificates.
recognized by BFC
(Upper limit) Authorising books in Limit for total of all =
field of specializations 60 hrs for 5 years
published by a reputed
20
publisher 2
___________________
Formal Education and 1. Actual
Training Activities (No (3) 2. 1 hours of
limit) 3. attendance __________
Participation in CPD
related lectures,
symposium, in-house Actual
(4) training, studying tour, 0.5 hours of
National and attendance
International __________
conferences etc.
Lectures exclude
Lecturer or Symposium Actual lecture routine teaching at
(5) 2
Panelist hours institutions and
____________ university
Hours spent
Participation in an at an
(6) 1
academic meeting academic ____________
meeting
Actual hours
Writing thesis, technical Subject to limit of 20
(7) 1 to write a
reports and others hours per year
report ____________
Presentation Papers and
This is applied only
other Activities (No limit)
when an applicant
Attending a committee Hours of
(8) 1 ______________ participates in active
etc. attendance
____________ discussions (such as
at round–table)
Only those with
urgency and in the
Part of Professional Hours spent
______________ public interest such
contribution in activities for
(9) 1 ______________ as emergency
such as emergency risk professional
__________ building risk
judgement work. contribution
judgement work
after earthquake etc.

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 PART II

(To be filled by National Committee)

1. Passed Professional Engineer Assessment Examination

(a) Examination

Discipline…………………….Roll No............................ Date of Passing……………………

(b) Experience including Continuous Professional Development

Date of Interview ....................................................

Assessment (in brief) ................................................………………………..

………………………………………………………………………………..
………………………………………………………………………………..
………………………………………………………………………………..

2. Conducted by member association ………………………………………………

3. Recommendations for Certification as Professional Engineer

Yes No

If yes, state discipline recommended

Discipline ...............................…………..

Reference No..........................…………..

Date........................................…………..

________
Signature

___________________________
Authorised Signatory’s designation

_______________________________
Name of professional engineering association

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 PART III

(For IEI’s use only)

Verification

Certification Approved / Not approved

Discipline .................................................... Registration No.............................................

Date of intimation of Certification to the applicant

Date of despatch of Professional Engineer Certificate

________
Signature

_________________________
Authorised Signatory’s Designation
for Board for Certification of Professional Engineer

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 (CONFIDENTIAL)
(Not applicable for renewal of certification)

To be filled by each Nominator and sent separately to BFC in a sealed envelop

(Ref. Item 5 of Guidelines)

Report on Shri/Smt………………………………………………………

1. How long have known the applicant? ………. Years

2. In what capacity? Employer Sr. Colleague Mentor

Colleague Friend Client

3. Do you recommended the applicant for certification as Professional Engineer

Yes No
4. If yes please give your own impression of the candidate and why you consider him/her a fit person to
be certified as professional engineer, identifying his/her engineering qualities & achievement (around 50
words)

Signature: ……………………………………………………………...
Name of the Nominator: ………………………………………………..
Correspondence Address ………………………………………………
……………………………………………….

E-mail id : ………………………………………………

Fellow No.: …………………………………………………….

P Eng No.: ……………………………………………………..

Name of the professional institution/society …………………………….

To
Board for Certification of Professional Engineer
The Institution of Engineers (India)
8 Gokhale Road
Kolkata – 700 020

For more information please visit our website: www.ieindia.org through home page Professional Engineer.
E-mail: ddg@ieindia.org / pe@ieindia.org
Phone: 033 2223-3296

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