Florida Board of Professional Engineers

2639 North Monroe Street, Suite B-112 Tallahassee, FL 32303

Fundamentals of Engineering Foreign Degree Application

FBPE FEFDA

093013

Fundamentals of Engineering Foreign Degree

CHECK LIST
Completed Application in its entirety Application has been notarized Attach passport photo or copy of valid drivers license Attach fee application fee ($3 ! "

Complete top portion of #erification of Education $elease and for%ard to appropriate educational institution(s" Evaluation of All Foreign &ranscripts by 'ne of the Approved Evaluators

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Fundamentals of Engineering Foreign Degree

FUNDAMENTALS OF ENGINEERING FOREIGN DEGREE APPLICATION (To be completed by FBPE File () Application () $3 Fee $eceived)

For 'ffice *se 'nly

PLEASE T!PE OR PRINT IN INK PRINT NAME AS !OU "ANT IT TO APPEAR ON !OUR "ALL CERTIFICATE

+ame -ailing Address

,ast +umber and .treet City County

First

-iddle Apt /lot ( .tate 0ip Code

1.ocial .ecurity numbers are mandatory pursuant to &itle 23 *nited .tates Code4 .ections 563 and 5627 and .ections 266!3 3(8"4 266!393(9"4 2 8!36::4 and 2 8!368;4 Florida .tatutes! Soc#$l Sec%&#ty '%mbe& )

Date of <irth

=ome &elephone +o! ( "

<usiness &elephone +o! ( "

Email Address

=ave you ever changed your name through marriage or through action of a court4 or have you ever been >no%n by any other name) ?E. +' if ?E.4 please provide a copy of the marriage certificate or legal court order! =ave you ever been convicted or found guilty4 or entered a plea of guilty or nolo contendre regardless of ad@udication4 of a crime in any @urisdiction4 or have you ever been found guilty by a military courtAmartialB (Do not include pending charges or nonAcriminal traffic violations!" ?E. +' Cf ?E.4 please list date4 @urisdiction (state D county"4 offense4 disposition and all other relevant information on attached sheet(s"! Ee are reFuired to as> that you furnish the follo%ing information as part of your voluntary compliance %ith .ection 34 *niform Guidelines on Employee .election Hrocedure (98:;" 23F$3;385 (August 364 98:;"! &his information is gathered for statistical and reporting purposes only and does not in any %ay affect your candidacy for licensure! R$ce( Ot)e&( Se*( Caucasian AfricanAAmerican =ispanic Asian +ative American -ale Female

EDUCATION(

C)ec+ )#,)e-t le.el o/ de,&ee $0$&ded) Type o/ De,&ee Rece#.ed( D#d yo% ,&$d%$te

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N$me 1 Add&e--eColle,e-2U'#.e& -#t#e- Atte'ded(

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Are you currently enrolledB ?E. +' Cf currently enrolled4 list anticipated date of graduation!

Cn %hat discipline of engineering %as or %ill your degree be issuedB

N$me 1 Add&e--eColle,e-2U'#.e&-#t# e- Atte'ded(

-onth/Day/?ear

=ave you filed an application %ith this office previouslyB ?E. +' Cf yes4 list the date of the last Engineer Cntern EIamination you have ta>en or %ere scheduled for) .pecial testing accommodations due to disability or religious conflicts %ill be processed at the time you register %ith E,.E. for the eIamination! NOTE( AFFIRMATION C have carefully read the Fuestions in the foregoing application and have ans%ered them completely4 %ithout reservations of any >ind4 and C declare and affirm that my ans%ers and all statements made by me herein are true and correct! .hould C furnish any false information in this application4 C hereby agree that such act shall constitute cause for the denial4 suspension4 or revocation of any license to practice in the .tate of Florida for the profession for %hich C am applying! Hersonally >no%n to me '$ CD sho%n7 &ype of CD

Appl#c$'t S#,' He&e 3333333333333333333333333333333333333333333333333333 D$te33333333333333333333333333 .&A&E 'F ( C'*+&? 'F ( " " ACJ+'E,EDGED <EF'$E -E &=C.KKKKKDA? 'F KKKKKKKKKK4 KKKKKKKK

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M! COMMISSION E4PIRES( FBPE FEFDA 093013 3

Fundamentals of Engineering Foreign Degree

5e&#/#c$t#o' o/ Ed%c$t#o' $'d T&$'-c&#pt Rele$-e Fo& E',#'ee& I'te&' (Fo&e#,' De,&ee
Cf you received your -!.!4 or Hh! D! in Engineering #' t)e U'#ted St$te-4 please complete all information pertaining to the Cnstitution and yourself and send it to the Cnstitutions you attended #' t)e U'#ted St$te-! &his document allo%s the college or university to for%ard your transcripts to the <oard 'ffice! PLEASE T!PE OR PRINT LEGIBL!6 N$me $'d Add&e-- o/ I'-t#t%t#o'(

N$me $'d Add&e-- o/ Appl#c$'t(

Soc#$l Sec%&#ty No6) D$te o/ Atte'd$'ce) D$te De,&ee A0$&ded) De,&ee A0$&ded) D#-c#pl#'e)

C am ma>ing application to the Florida <oard of Hrofessional Engineers for Fundamentals of Engineering EIamination and subseFuent registration as an Engineer Cntern! Eith this understanding4 C reFuest confirmation of this information by completion of this document! Hlease for%ard this document4 along %ith an official copy of my transcript4 to EC ,icensure &echnician4 Florida <oard of Hrofessional Engineers4 3538 +! -onroe .treet4 .uite <A9934 &allahassee4 Florida 333 3! S#,'$t%&e o/ Appl#c$'t) KKKKKKKKKKKKKKKKKKKKKKKKKKKK D$te) KKKKKKKKKKKKKKKKKKKKKK

RETURN THIS DOCUMENT AND &$A+.C$CH& &') Flo&#d$ Bo$&d o/ P&o/e--#o'$l E',#'ee&Atte't#o'( F%'d$me't$l- De-+ 789: N6 Mo'&oe St&eet; S%#te B<==7 T$ll$)$--ee; Flo&#d$ 979>9

(SCHOOL SEAL

FBPE FEFDA

093013 !

Fundamentals of Engineering Foreign Degree

I'-t&%ct#o'- /o& Fo&e#,' De,&ee Appl#c$'t- to Rece#.e El#,#b#l#ty /o& t)e NCEES F%'d$me't$l- E*$m#'$t#o'
T)e Flo&#d$ Bo$&d o/ P&o/e--#o'$l E',#'ee&- )$- e'te&ed #'to $ co't&$ct 0#t) NCEES to $dm#'#-te& t)e e',#'ee&#', e*$m#'$t#o'-6 ?ou must file your application %ith the <oard of Hrofessional Engineers4 and you must receive notice of eligibility to sit for eIamination4 prior to registering %ith +CEE.4 at %%%!ncees!org! If you were previously approved to sit for the examination in Florida, please submit the FE ReExam Application. )ttp(22/bpe6o&,2l#ce'-%&e2$ppl#c$t#o'<p&oce--2/%'d$me't$l-<e*$m#'$t#o'</e Cn order to Fualify for the Fundamentals of Engineering EIamination4 you must meet the Fualifications listed in Chapter 2:94 Florida .tatutes4 (F!.!" and $ule 59G964 Florida Administrative Code (F!A!C!"! Engineer Cntern applications are processed by our office staff and are revie%ed by the <oards Application Committee at such time as they are deemed complete! Cf the Committee denies your application4 you %ill be notified of the denial and your options at that time! &he Florida <oard of Hrofessional Engineers has adopted a Foreign Degree rule that provides for application under .ection 2:9! 934 F!.! for applicants %ith a degree from a school or college from outside the *nited .tates! Chapter 59GA3 ! 5 F!A!C!4 provides for a revie% of an applicants educational curricula by the <oards Educational Advisory Committee to determine if an applicants educational bac>ground conforms to the curricula reFuirements of the Accreditation <oard for Engineering &echnology (A<E&"! &he reFuirement of having your degree evaluated is to assist our Educational Advisory Committee in determining if your educational bac>ground is substantially comparable to the criteria imposed by EAC/A<E& and .ection 59G96A3 ! :4 F!A!C!! Ct is important that all educational documents and all transcripts be evaluated in order to supply the Committee %ith the pertinent educational bac>ground information! &he follo%ing is a list of the course reFuirements! .ee .ection 59G96A3 ! specifically reFuired courses! -athematics D <asic .ciences Engineering .cience D Design =umanities D .ocial .ciences :(9"A(5"4 F!A!C! for

33 credit hours 2; credit hours 95 credit hours

Competency in English ,anguage may be satisfied by receiving a score of 66 (or higher" on the &'EF, paper based eIam4 393 (or higher" on the &'EF, computer based eIam7 passing score on the G$E eIamination or certified statement from employer!

FBPE FEFDA

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Fundamentals of Engineering Foreign Degree

APPLICATION INSTRUCTIONS Applications must be received by the <oard deadline! Applications received after the deadline %ill be processed for the follo%ing eIam date! Ee advise that you mail your application at least ten days prior to the receipt date! &his pac>et should contain the follo%ing forms) Application /Hrofile Data for Engineer Cntern EIamination (Foreign Degrees" #erification of Education $elease

NOTE( .uccessful completion of the F<HE .tudy Guide4 covering Chapter 2:94 Florida .tatutes and $ule 59G964 Florida Administrative Code4 is reFuired for licensure! &he .tudy Guide is an online teIt %ith thirty three (33" Fuestions! ?ou %ill be sent a lin> to the %ebsite %ith logon information! ?ou %ill then complete the .tudy Guide online and your results %ill be sent directly to F<HE for inclusion %ith your file! ?ou %ill also receive a Certificate of Completion once you have successfully completed the .tudy Guide!

FORMS AND INSTRUCTIONS USED AS A PART OF THE APPLICATION PROCESS ITEM ?=( APPLICATION 2 PROFILE DATA Attach passport photo or copy of a valid drivers license to a separate blan> page and attach it to this form! Hlease sign the bac> of the photograph in the event they become separated from the application! ?our %all certificate %ill be issued under the name as it appears on the application! All Fuestions on this document must be ans%ered! Attach a chec> or money order in the amount of $3 ! to the application / profile data document! -a>e the chec> payable to the Florida <oard of Hrofessional Engineers! &he <oard %ill not accept or process any application until the complete fee has been received and all Fuestions on the Application / Hrofile Data document have been ans%ered! Cf you should omit the fee %hen you submit your application4 the <oard office %ill return your application to you! Ehen you receive your returned application4 you can resubmit it at that time %ith the appropriate fees! +ote) *nder the Federal Hrivacy Act4 disclosure of .ocial .ecurity numbers is voluntary unless specifically reFuired by Federal statute! Cn this instance4 social security numbers are mandatory pursuant to &itle 23 *nited .tates Code4 .ections 563 and 5627 and sections 266!3 3(8"4 266!393(9"4 2 8!36::4 and 2 8!368;4 Florida .tatutes! .ocial .ecurity numbers are used to allo% efficient screening of applicants and licensees by a &itle C#AD child support agency to assure compliance %ith child support obligations! .ocial security numbers must also be recorded on all professional and occupational license applications and %ill be used for licensee identification pursuant to the Hersonal $esponsibility and Eor> 'pportunity $econciliation Act of 9885 (Eelfare $eform Act"4 9 2 Hub!,!9834 .ec! 39:! ITEM ?7( 5ERIFICATION OF EDUCATION AND TRANSCRIPT RELEASE Hlease complete the top portion and submit this document directly to all institution(s" you attended #' t)e U'#ted St$te- (<!.!4 -!.!4 and Hh! D! in Engineering"! &he institution(s" %ill complete this document and for%ard it along %ith a certified transcript directly to the <oard 'ffice! 'riginal transcripts of degrees completed outside the *nited .tates are to be submitted to the evaluation service (see item (5"! Hlease note) L#erification of Education $eleaseM form is needed only for 'riginal L'fficialM transcripts for degrees &ece#.ed #' t)e U'#ted St$te- (<!.!4 -!.!4 Hh! D! in Engineering" 'riginal transcripts for degrees earned outside the *nited .tates should be sent to the evaluation company (see item (:"!
FBPE FEFDA 093013 6

Fundamentals of Engineering Foreign Degree

ITEM ? 9( ONLINE STUD! GUIDE $ead Chapter 2:94 F!.! and $ule 59G964 Florida Administrative Code and complete the online .tudy Guide on ,a%s and $ule! *se the %ebsite lin> that %ill be sent to you and complete the study guide online! $etain a copy of the Florida ,a%s and $ules for future reference! A passing score of 8 N or more is reFuired per $ule 59G96A3 ! 95! ITEM ?8( E5ALUATION OF UNDERGRADUATE DEGREE Fo&e#,' %'de&,&$d%$te de,&ee- m%-t be e.$l%$ted; &e,$&dle-- o/ $'y po-t<,&$d%$te de,&eeobt$#'ed #' t)e U'#ted St$te-6 Evaluations must be completed by evaluation services that are approved by the <oard! &hese services evaluate to EAC/A<E& standards and 59G96AF!A!C! &he current list of evaluation services are listed as follo%s) Oosef .ilny D Associates4 Cnc! Cnternational Education Consultants :9 9 .E 9 3 Avenue -iami4 Florida 339:3 &el) (3 6" 3:3A9595 0006@-#l'y6com +CEE. Credentials Evaluations H! '! <oI 95;5 Clemson4 .C 38533 &el) (;52" 562A5;32 0006'cee-6o&,2c&ede't#$l-e.$l%$t#o'-

During the processing of this application process4 you %ill receive) 9> d$y 'ot#ce o/ -t$t%- A?ou may also chec> the status of your application by visiting our %eb site and selecting the search lin> to 0006my/lo&#d$L#ce'-e6com! Not#ce A that your file is complete for <oard revie% Not#ce o/ App&o.$l A Ehen you receive your +otice of Approval card from the <oard4 you must then register %ith +CEE. at 0006'cee-6o&, or Not#ce o/ De'#$l A .hould your application be denied4 you %ill receive a +otice of Denial and information regarding your option to appeal! SPECIAL TESTING ACCOMMODATIONS APPLICATION FOR DISABILIT! ACCOMODATION Cf you reFuire special accommodation because of a physical or mental impairment that substantially limits one or more ma@or life activities4 you may reFuest special assistance %ith the eIamination %hen you contact E,.E. to register for the eIamination RELIGIOUS CONFLICTS -odifications to reporting times or alternate test days due to religious beliefs must be processed at the time you register %ith E,.E.! Cf you have any Fuestions4 please contact Florida <oard of Hrofessional Engineers Attn) Fundamentals Des> 3538 +! -onroe .treet4 .uite <A993 &allahassee4 Florida 333 3 &elephone +umber (;6 " 639A 6

FBPE FEFDA

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