Engineering Council of South Africa

(13/04/2012)

Form A2.1

TRAINING/EXPERIENCE REPORT
PROFESSIONAL ENGINEERS
Page No: ____ of___

Surname and Initials:

______________________________________________________________
Discipline of Engineering: ___________________________________________________________
(e.g. Civil/Mech etc.)
Consult the enclosed Information Sheet (Sheet A2) before completing this report.

Period No:

Date from:

Employers Name and address:

to:

Position held:

No of
weeks:

Did you train under a Commitment

and Undertaking (CU)?

Yes
No

If yes, provide number of CU No:

No: ___________

Supervisors Name and address:

Supervisors
Signature:
ECSA Registration No:

Date:

Signature of Applicant: ________________________________

Date: ________________