ENGINEERING COUNCIL

OF

SOUTH AFRICA
Office Use

Private Bag X 691

BRUMA 2026
Tel:
(011) 607-9500
Fax:
(011) 622-9295

Waterview Corner, 1st Floor,

2 Ernest Oppenheimer Avenue
Bruma Lake Office Park
BRUMA
Ref.:

Email: engineer@ecsa.co.za
Website: www.ecsa.co.za

Johannesburg
2198

DECLARATION
I, _______________________________________________________________________
(full names) have submitted an application to The Engineering Council of South
Africa (ECSA) for Registration as a Professional Engineer/Candidate
Engineer/Educational Evaluation (delete inapplicable) on
I undertake to abide by all the provisions of the Engineering Profession Act,
2000 (Act No. 46 of 2000) and any Rules published thereunder, including
the Code of Professional Conduct. I declare that Section 19(3)(a) of the Act
does not preclude me from registration. I declare that, to the best of my
knowledge, all the information contained in my application is true.

Signature: _________________________ (To be signed in presence of Commissioner

of Oaths)

Sworn to/Affirmed before me at ___________________________

on this the ________ day of _____________________(month & year) by the deponent
who acknowledged that he/she knows and understands the content of the
declaration, that the facts herein contained are true and correct and that he/she
considers the oath to be binding on his/her conscience OR that he/she truly
affirm that the content of this declaration are true

Commissioner
of
Oaths:
(Commissioners stamp)