PE Application Rev 4
PE Application Rev 4
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
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
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FOR OFFICE USE ONLY
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PE001/Rev04
NA NA NA
NA
NA NA NA
NA
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Enclose attested photocopies of each of the above certificates
PE001/Rev04
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5. Continuous Professional Development Programme(s)/Activities. (Refer Annexure - III)
5.3 Professional contributions in emergency works (e.g. Flood Relief, Earthquake, Fire Fighting etc.)
Enclose supporting documents for Sl. No. 5.
Agriculture Aerospace
Architecture Computer
Chemical Civil
√ Electrical Electronics & Telecommunication
Environmental Mining
Marine Metallurgy & Material
Mechanical Production
Textile
(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.
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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 .”.
2. Professional Development
Nos.
Programmes’ (CPD) Certificate (s)
EMAIL: mydiary906@gmail.com
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Annexure - I
The Institution of Engineers (India)
Professional Engineers
PE002/Rev000
Format for CPD Report
Date of CPD
Credit hour Outcome of
the Weight Applicable
Sl.No CPD Program obtained(MxH the
Program Factor(M hours(H)
) Program
m )
National Power Training institute 0. Actua
1
5 l
0. hours
Actua
2 National Power Training institute
5 l
0. hours
Actua
3 HITACHI ABB
5 l
hours
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Signature of
Candidate
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Annexure - II
The Institution of Engineers (India) PE Cell
Professional Engineers PE003/Rev000
Format for Self Appraisal Report
1 Name:
.
Shona Balaji S S
2 Qualifications:
.
1.BE
2.
3.
4.
5.
3 Specialization:
.
Electrical and Electronics engineering
4 Core Competencies:
.
From 2014 I have been the single point contact for the OEM to manage and
deliver the engineering mile stones.
I was a part of India’s first Wind and solar hybrid project when I was with
Gamesa renewables.
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Signature of Candidate
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Annexure - III
CPD001/Rev04/01 NOV 2019
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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.
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