PE001/Rev04

The Institution of Engineers ( India)

8, GOKHALE ROAD, KOLKATA 700 020
APPLICATION FOR PROFESSIONAL ENGINEER (PE)
(FRESH/RENEWAL)

Name : _______________________ ________________________ __________________________

Last Name Middle Name First Name
In Capitals (As indicated in BE/B.Tech/Equivalent Certificate)

DETAILS OF PAYMENT
(A) NEFT/RTGS/IMPS/Online Net Banking Transfer to IEI Account, please mention the following:-
Beneficiary Name : THE INSTITUTION OF ENGINEERS (INDIA)
Amount (Rs/$)_________________________________
Account No. : 012104000094674 IFSC No. : IBKL0000012 Swift Code – IBKLINBB135
Bank Name & Branch : IDBI Bank, Siddha Point, Ground Floor, 101 Park Street, Kolkata 700 016
Transaction date : Name of Bank & Branch______________________________
Transaction ID/UTR No./Payment Reference No. :- ________________________________________
After NEFT/Online Net Banking Transfer to IEI Account, please enclose the transaction slip generated

(B) In case of payment by Draft

Draft No.____________________ Amount (Rs/$)_______________ Date _____________

Name of Bank & Branch
_______________________________________________________________________
DETAILS OF BANK ACCOUNT OF THE CANDIDATE (Necessary in cases of refund of Fees)

Account holder’s Name ________________________________________________________________

Name of the Bank & Branch ___________________________________________________________
Account number __________________________________________IFSC No. ___________________

Note:- Please enclose i) Cancelled cheque leaf bearing the Name of A/C holder OR ii) photocopy of
the first page of bank pass book containing name of A/C holder, A/C No., IFS Code

--------------------------------------------------------------------------------------------------------------------------------
FOR OFFICE USE ONLY

“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 1 of 8
 PE001/Rev04

The Institution of Engineers

( India) Paste latest
Photograph
8, GOKHALE ROAD, KOLKATA 700 020

APPLICATION FOR PROFESSIONAL ENGINEER (PE)

(FRESH/RENEWAL)
.
(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 Y Y Y Mobile No...............................................
Date of Birth: Each item to be self
attested
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

Ph D or Equivalent Discipline/Subject University Year of Passing

Any other non-engineering Post Graduation professional qualifications:

...........................................................................................................................................................................
...........................................................................................................................................................................
...........................................................................................................................................................................
Field of specialisation in engineering, if any: -
………………………………………………………………………………………………….......................
“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 2 of 8
Enclose attested photocopies of each of the above certificates
PE001/Rev04

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

along with membership no.
Each item to be
(a).................................................................................................................................... self attested.

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

4. Record of engineering experience in chronological order after passing BE/B.Tech or equivalent.

(if required separate annexure may be added).

Employer/Client Major job responsibilities

Dates Job Title
(if self employed/consultant)

5. Continuous Professional Development Programme(s)/Activities. (Refer Annexure - III)

“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 3 of 8
 5.1 Recognised Training Programme(s), Conferences, Seminars, Workshops, Technical Presentations
attended /participated. (Refer format Annexure - I)
Each item to be self
attested.
.
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:

Agriculture Aerospace
Architecture Computer
Chemical Civil
Electrical Electronics & Telecommunication
Environmental Mining
Marine Metallurgy & Material

Mechanical Production

Textile

7. Self-appraisal for certification as Professional Engineer (Refer format Annexure II)

8. Declaration:
(A) CONFORM TO THE CODE OF ETHICS OF THE ECONOMY WHERE I PRACTICE;
(B) BE ACCOUNTABLE FOR ACTIONS WHERE I PRACTICE;
(C) AGREE TO EXCHANGE OF MY DATA AMONGST MEMBERS.
(D) I WISH TO BE CERTIFIED AS PE (I) IN DISCIPLINE AS MENTIONED IN THE APPLICATION FORM.
(E) I AGREE TO ABIDE BY THE CODE OF ETHICS ESTABLISHED FOR PROFESSIONAL ENGINEERS AND TO BE
HELD INDIVIDUALLY ACCOUNTABLE FOR MY ACTIONS.

(F) I HAVE NO OBJECTION AGAINST MY CERTIFICATION PROCESS BEING STOPPED, SHOULD THERE BE ANY
INACCURACY IN THE SUBMITTED INFORMATION.
(G) I HAVE NO OBJECTION AGAINST MY CERTIFICATE BEING TERMINATED AFTER CERTIFICATION ACCORDING
TO PREVAILING RULES ON THE DATE OF TERMINATION AS PROFESSIONAL ENGINEER.
(H) I AGREE THAT THE DECISION ON CERTIFICATION AND TERMINATION SHALL BE BINDING ON ME.

“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 4 of 8
 PE001/Rev04

“I, solemnly declare that the documents submitted for application towards P Eng Certification are authentic
and the information given by me above is true to the best of my knowledge and belief. If the information
submitted by me are found to be fake or information furnished by me are false, I am solely responsible for
the same and my application/certification may be rejected/ceased without assigning any reason. I hereby
give my full consent to include my name and contact information as they are now or may be altered
hereafter in all the directories/lists of PE as deemed fit by the Institution. I also undertake to abide by
Professional Conduct rules and/or Code of Ethics that the Council may frame from time to time .”.

Enclosures : 1. Qualification Certificate Nos.

2. Professional Development
Nos.
Programmes’ (CPD) Certificate (s)

3. Other please specify

4. Soft Copy of Application in the

form of CD.

To be forwarded by the Head of the organization/HoD/Principal of the Institution

NAME:

DESIGNATION:

NAME OF THE ORGANISATION:

CONTACT NO.:

EMAIL:

SIGNATURE WITH DATE &

SEAL:

Date : Applicant’s Signature ........................................

Applicant’s Name ..............................................

“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 5 of 8
 The Institution of Engineers (India) Annexure - I
Professional Engineers
PE002/Rev000
Format for CPD Report

Name:

Date of CPD
Applicabl Credit hour
Sl.N the Weight Outcome of the
CPD Program e obtained(MxH
o Program Factor(M Program
hours(H) )
m )

“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 6 of 8
 Signature of Candidate
Date of CPD
Applicabl Credit hour
Sl.N the Weight Outcome of the
CPD Program e obtained(MxH
o Program Factor(M Program
hours(H) )
m )

Signature of Candidate

“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 7 of 8
 Annexure - II
The Institution of Engineers (India) PE Cell
Professional Engineers PE003/Rev000
Format for Self Appraisal Report
1 Name:
.

2 Qualifications:
.
1.
2.
3.
4.
5.
3 Specialization:
.

4 Core Competencies:
.

5 Design/Patents/Innovation/ Major Project Handled Details:

.

6 Management/Leadership:
.

7 Special Achievements if any:

.

Signature of Candidate
“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 8 of 8
“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 9 of 8
 Annexure - III
CPD001/Rev04/01 NOV 2019

Continuous Professional Development For

Professional Engineers Certification Annexure - IV
CPD Weight Applicable Credit Hours
Classification Type Applicable CPD Program Factor Hours Obtained Remarks
(Multiplier)-M (H) (M x H)
Formal Education Doctorate 2 30
Upgrade In Post Graduate Degree 2 25
Engineering / Limit for total of all = 60
(1)
Management duly
recognized by BFC Post Graduate Diploma 2 20
(Upper limit)
Formal Education Post Graduate Limit for total of all = 75
Upgrade in Correspondence /
Engineering / (2) Certified online courses 1.5 20
Management. offered by reputed
Institutes /Organisations
Authoring books in field of
specializations published
2 20
by a reputed publisher
(having ISBN No.)
Authoring Books (3)
Contribution in Authoring
3 hrs for
any Chapter of books
2 each
published by a reputed
chapter
publisher
1.
Continuing Education Actual
and Training Activities (4) 2. 0.5 hours of
(No limit) attendance
3.

Patent Applied 1.5

10 for each
(5)
patent
Patent Granted 2.5
Delivered Lecture (being Actual
(6) invited) or Symposium 2 lecture
Panelist hours Lectures exclude routine
Participation in an Hours teaching at institutions and
academic meeting of spent at an university
Presentation Papers and (7) 1
reputed Forum/Institute/ academic
other Activities (No
Organisation meeting
limit)
Paper publication in
Journal or presentation of 5 to 10
Subject to limit of 20 hours
(8) paper in National / 1 hours to
per year
International Conference write one
with ISSN Code/Patent paper
Writing Technical Report 5 to 10
(if confidential hours to Subject to limit of 20 hours
(9) 1
undertaking to be given by write one per year
the applicant) report
This is applied only when
Attending an Expert
(10) 5 hrs per an applicant participates
committee meeting e.g.
0.5 selection in active discussions (such
Selection Committee
committee as at round–table)
Meeting like NIT, IEEE etc.
Subject to limit of 10 hours
Part of Professional Hours
contribution such as spent for
Design, Research & profession
(11) 1
Development, Project al
Management in the field of contributi
Engineering & Technology on
Annexure-III
1. Maximum no. of hours that can be claimed in respect of each of the category of CPD is indicated against each category. CPD hours have to be claimed from at
least 3 categories and total no. of hours claimed from each of the category should not be less than 5 (five) hours.
2. Every applicant for P Eng has to secured at least 75 Credit Hours for fresh applicants since Graduation and 125 Credit Hours within his/her five years
certification validity period for renewal.
3. The record of CPD activity will have to maintain in CPD record book provided by IEI for this purpose.

“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 10 of 8
4. The number of Credit Hours will be calculated by multiplying the number of hours actually spent for the CPD activities by a pre-determined weighted factor.

“Please necessarily submit the softcopy of this application in the form of CD along with the hardcopies” Page 11 of 8