PE Rev- 12

(For office use)

The Institution of Engineers ( India)

8, GOKHALE ROAD, KOLKATA 700 020

Paste latest
Photograph

APPLICATION FOR PROFESSIONAL ENGINEER

(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
sponsor after personal
verification

Nationality:
2. Academic Qualifications:
BE / B. Tech or Equivalent

Discipline

University

Year of Passing

ME / M Tech or Equivalent

Discipline/Specialisation

University

Year of Passing

Discipline/Subject

University

Year of Passing

Ph D or Equivalent

Any other non-engineering Post Graduation professional qualifications:

...........................................................................................................................................................................
...........................................................................................................................................................................
Field of specialisation in engineering, if any: .......................
Enclose attested photocopies of each of the above certificates
Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies.

Page 1 of 8

3.Name & Category of membership of engineering related professional institution(s).

(a)....................................................................................................................................
(b)...................................................................................................................................
(c)....................................................................................................................................
(d)....................................................................................................................................

Each sponsor
has to sign one
item after due
verification.

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.
Sl.
No.
1.

Title/Subject

Duration & Dates

Nature of Participation

Conducting
Organisation

2.
3.
4.

Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies.

Page 2 of 8

Each sponsor 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 transfer 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 transfer to IntPE (I) register is Rs.10, 000/or US$ 500 (for applicants other than citizen of India & Nepal).]
Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies.

Page 3 of 8

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 :
Applicants Signature ........................................
Applicants Name ..............................................
Nos.
Enclosures :

1. Qualification Certificate
2. Professional Development
Programmes Certificate (s)
3. Bank Draft/Credit Card
Authorisation
4. Others

Sponsors :

Name

Rs,

No.

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)

Membership No., Grade &

Name of recognised professional Institution

Signature

1.
2
3.

Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies.

Page 4 of 8

Continuous Professional Development

Classification

Type

Formal
Education
Upgrade
In
Engineering/
Management
duly
recognized by BFC (Upper
limit)

Formal
Education
Upgrade in Engineering/
Management
duly
recognized by BFC
(Upper limit)

Formal Education
Training Activities
limit)

and
(No

(1)

(2)

CPD Weight
Factor
(Multiplier)

Applicable CPD
Program
Doctorate
_____________
Post
Graduate Degree
___________________
_________
Post Graduate Diploma
___________________
_________
Post
Graduate
Correspondence/ online
course (including those
gained through the
internet)
___________________
_________
Authorising books in
field of specializations
published by a reputed
publisher
___________________

(3)

1.
2.
3.

(4)

Participation in CPD
related
lectures,
symposium, in-house
training, studying tour,
National
and
International
conferences etc.

(5)

Lecturer or Symposium
Panelist

2
2

Applicable
Hours

30
25

20

Annexure - I
Credit Hours
Obtained

__________
__________

Participation in
academic meeting

an

(7)

Writing thesis, technical

reports and others

__________

20
__________

Attending a committee
etc.

(9)

Part of Professional
contribution in activities
such as emergency risk
judgement work.

All
achievements
shall be supported
with records and
certificates.
Limit for total of all =
60 hrs for 5 years

20

Actual
hours
of
attendance

0.5

Actual
hours
of
attendance

__________

__________

Presentation Papers and

other Activities (No limit)
(8)

All
achievement
shall be supported
with records and
certificates.
Limit for total of all =
60 hrs for 5 years

Actual lecture
hours
____________

(6)

Remarks

Hours spent
at
an
academic
meeting
Actual hours
to write a
report

Hours
of
attendance

Hours spent
for
professional
contribution

Lectures
exclude
routine teaching at
institutions
and
university

____________

____________
______________
____________

______________
______________
__________

Subject to limit of 20
hours per year
This is applied only
when an applicant
participates in active
discussions (such as
at roundtable)
Only those with
urgency and in the
public interest such
as
emergency
building
risk
judgement
work
after earthquake etc.

Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies.

Page 5 of 8

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 Signatorys designation
_______________________________
Name of professional engineering association

Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies.

Page 6 of 8

PART III
(For IEIs 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 Signatorys Designation
for Board for Certification of Professional Engineer

Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies.

Page 7 of 8

(CONFIDENTIAL)
(Not applicable for renewal of certification)
To be filled by each Sponsor 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?

2.

In what capacity?

3.

. Years
Employer

Sr. Colleague

Mentor

Colleague

Friend

Client

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 Sponsor:
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

Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies.

Page 8 of 8