Department of Public Works and Highways

ACCREDITATION OF MATERIALS ENGINEERS

APPLICATION FORM
Application Number
New Applicant Accredited Materials Engineer I, indicate accreditation number

2" x 2" Photo

Name (Last) PRC License Number Home Address : : (First) Valid Until (Middle)

Office Name Office Address Position Title Home Tel. No. Nationality

: : : : : Office Tel. No. Birthday Sex Mobile No. Civil Status

Education
(Limit to Tertiary Level Up) Degree School Year Graduated

I certify to the correctness of the foregoing. ___________________________________ Signature over printed name ____________________________ Date Preferred Venue of Examination Manila Cebu City Davao City

Date of Examination (Do no fill up): __________________________________________________________________

INSTRUCTIONS
1. Type or print the data on each space clearly. 2. Attach to this Application Form the following requirements: a. Xeroxed copy of valid Professional Regulation Commission (PRC) Identification Card

b. Two 2" x 2" photographs (one to be pasted in the Application Form and the other is for Notice of Examination Schedule) c. One 1" x 1" photograph 3. Submit the Application Form and the requirements to: The Chief Materials Quality Control and Hydrology Division Any Regional Office of the Department of Public Works and Highways 4. Application forms must be submitted at least forty (40) days before the scheduled accreditation examination. 5. Applicants shall obtain the Notice of Examination Schedule from the DPWH Office where the application was filed within, one (1) week before the scheduled examination. The notice shall confirm the date, time and place of examination. This notice must be presented to the DPWH examination proctor during the examination.

EXAMINATION COVERAGE Construction materials specifications, sampling and testing procedures, test results calculations/interpretation/evaluation, DPWH minimum testing requirements, materials quality control terminologies/practices, duties and responsibilities of materials engineers, and quality control implementation/documentation.