IntPE

IntPE001/Rev000/Dt16012017
(For office use)

The Institution of Engineers ( India)

8, GOKHALE ROAD, KOLKATA 700 020
Paste latest
APPLICATION FOR Photograph
INTERNATIONAL PROFESSIONAL ENGINEER (IntPE)
(FRESH/RENEWAL)
PART I
(To be filled by the applicant in his/her handwriting using black ink only)
(Please refer to the ‘Systems & Procedures 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
signed by at least one
Nationality: nominator after
personal verification.
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: -
………………………………………………………………………………………………….......................
Enclose attested photocopies of each of the above certificates

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 IntPE001/Rev000/Dt16012017

3. Name & Category of membership of related engineering professional institution(s) Each nominator
has to sign one
along with membership no. item after due
verification.
(a)....................................................................................................................................
(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 for last five years, starting from current
year.
5.1 Recognised Training Programme(s), Conferences, Seminars, Workshops, Technical Presentations
attended /participated. (Refer format Annexure - I)

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 IntPE001/Rev000/Dt16012017

Each nominator is
expected to sign at
least one item after
5.2 Books/Articles/Research/Technical Reports written by applicant due verification.

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 International Professional Engineer applied for:

Civil Electrical

Chemical Mining

Mechanical Electronics & Telecommunication

Textile Marine

Environmental

7. Assessment Examination, if applicable. Yes No

7.1 Choice of Examination Centre Code
7.2 Discipline Specialisation (wherever available) : ……………………………………………………...
(Please see ‘Assessment Examination’ in www.ieindia.org for the available specialisations in Module 2
(Part II) and choice of Examination Centre)
8. Self-appraisal for certification as International Professional Engineer (Refer format Annexure II)
9. 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 OF INTERNATIONAL RECOGNITION AGREEMENT.
(d) I WISH TO BE CERTIFIED AS INTPE (I) IN DISCIPLINE AS MENTIONED IN THE APPLICATION FORM.
(e) I AGREE TO ABIDE BY THE CODE OF ETHICS ESTABLISHED FOR PROFESSIONAL ENGINEERS AND TOBE
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 INTERNATIONAL PROFESSIONAL
ENGINEER.
(h) I AGREE THAT THE DECISION ON CERTIFICATION AND TERMINATION SHALL BE BINDING ON ME.
(i) I HEREBY SWEAR THAT THE CONTENTS OF THE ITEMS DESCRIBED IN THIS APPLICAITON ARE TRUE
AND CORRECT.

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

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

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 BFC Secretariat
Intpe002/Rev000/Dt16012017

Nos.
Enclosures : 1. Qualification Certificate
2. Professional Development
Programmes’ Certificate (s)
3. Bank Draft/Credit Card Rs. DD No.
Authorisation
4. Others

5. Soft Copy of Application

in the form of CD.

Nominations : From personal knowledge of the applicant and in consideration of his/her qualifications as stated in the form,
we recommend him/her as being in every way a fit and proper person to be certified as International
Professional Engineer. To be filled by each Nominators and sent separately confidentially to BFC Secretariat
in a sealed envelope (Not required for renewal applications. Refer format Annexure III)

Sl. Membership No., Grade & Signature

Name
No Name of recognised professional Institution
1.

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 Annexure - I
Institution of Engineers (India) BFC Secretariat
Intpe002/Rev000/Dt16012017
International Professional Engineer
Format for CPD Report
Name:
CPD
Applicable Credit hour Outcome of the
Sl.No CPD Program Weight
hours obtained Program
Factor

Signature of Candidate

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 Annexure - II
Institution of Engineers (India)
International Professional Engineer BFC Secretariat
Intpe003/Rev000/Dt16012017
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

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 Institution of Engineers (India) Annexure - III
International Professional Engineer BFC Secretariat
Format for Nominator’s Report Intpe003/Rev000/Dt16012017
CONFIDENTIAL
(Not applicable for renewal of certification)
To be filled by each Nominator and sent separately confidentially to BFC in a sealed envelop

Report on Shri/Smt……………………………………………………………………………………………………………………………………….
1. How long have known the applicant? ………. Years
2. In what capacity? Employer Sr. Colleague Mentor
Colleague Friend Client
3. Do you recommend the applicant for certification as International Professional Engineer? Yes No
(Please tick)
4. If yes please give your own impression of the candidate and why you consider him/her a fit person to
be certified as International professional engineer.
Engineering qualities and core competencies

a) Innovative

b) Analytical
Ability

c) Problem
Solving
Ability

d) Core
competency

Signature : ……………………………………………………………………………………………………………………………
Name of the Nominator : …………………………………………………………………………………………………………………………….
Correspondence : …………………………………………………………………………………………………………………………….
Address ……………………………………………………………………………………………………………………………
E-mail id : …………………………………………………………………………………………………………………………….
Fellow No. : …………………………………………………………………………………………………………………………….
P Eng No. : …………………………………………………………………………………………………………………………….
Name of the professional institution/society …………………………………………………………………………………………………….
To
Board for Certification of International Professional Engineer For more information please visit our website: www.ieindia.org.
4th Floor (Membership Department) E-mail: [email protected]
The Institution of Engineers (India) Phone: 033 40106232/275
8 Gokhale Road, Kolkata – 700 020

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 Continuous Professional Development

CPD Weight
Applicable Credit Hours
Classification Type Applicable CPD Program Factor Remarks
Hours Obtained
(Multiplier)
Doctorate 2 30 All achievement shall be
Formal Education
supported with records
Upgrade In Engineering /
(1) and certificates.
Management duly Post Graduate Degree 2 25
recognized by BFC (Upper
Limit for total of all = 60
limit) Post Graduate Diploma 2 20 hrs for 5 years

Post Graduate
Correspondence / online All achievements shall be
1 20
course (including those supported with records
Formal Education gained through the internet) and certificates.
Upgrade in Engineering / (2)
Management.
Authorizing books in field of Limit for total of all = 60
specializations published by 2 20 hrs for 5 years
a reputed publisher

1.
Continuing Education and Actual
Training Activities (No (3) 2. 0.5 hours of
limit) attendance
3.

Participation in CPD related

lectures, symposium, Actual
(4) studying tour, National and 0.5 hours of
International conferences attendance
etc.

Delivered Lecturer or Actual lecture

(5) 1
Symposium Panelist hours Lectures exclude routine
Hours spent at teaching at institutions and
Participation in an academic university
(6) 0.5 an academic
meeting
meeting

Writing thesis, technical 5 to 10 hours Subject to limit of 20 hours

(7) 1 to write one
reports and others per year
report / thesis
Presentation Papers and This is applied only when
other Activities (No limit) an applicant participates in
(8) Hours of
Attending a committee etc. 0.5 active discussions (such
attendance
as at round–table)
Subject to limit of 10 hours
Only those with urgency
Part of Professional and in the public interest
Hours spent for
contribution in activities such as emergency
(9) 1 professional
such as emergency risk building risk judgement
contribution
judgement work. work after earthquake etc.
Subject to limit of 20 hours

1. Maximum no. of hours that can be claimed in respect of each of the category of CPD are 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. Satisfactory evidence of minimum 50 hours of CPD each year over the last 5 years i.e. totaling to minimum 250 hours in a 5
years cycle as per the format prescribed clearly mentioning the outcome obtained out of CPD programmes.
3. The record of CPD activity will have to maintain in CPD record book provided by IEI for this purpose.
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 weightage factor.

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