PECE Checklist 2021 Official
PECE Checklist 2021 Official
APPLICANT’ S CHECKLIST
Covering Letter
Curriculum Vitae
Copy of Diploma
Recent Passport Size Photographs, White Background with Name Tag (Coat & Tie for Men)
Applicant Declaration
Note:
1. Triplicate copies of the accomplished application forms, including copies of all supporting
documents must be submitted; A4 - size (8.27 x 11.69 inches) of paper not less than substance 20
(80 gms) thickness shall be used throughout; photocopies of large documents shall be reduced
accordingly. Each set shall be submitted in Blue Clear book, complete with table of contents/tab.
2. All applications must be originally- signed by the applicant and shall be delivered or mailed
to:
TABLE OF CONTENTS
SECTION
04. PRC APPLICATION FORM NO. 004 (REV. 2007 SEPTEMBER) page - -
05. PROFESSIONAL EXPERIENCE PRC FORM NO. 104 (REV. JULY 2002) page - -
Dear Sir:
In accordance with the provisions of the newly-enacted Electronics Engineering Law (RA
9292), I have the honor to apply herewith for the upgrading of my Electronics Engineer
license number 0034877 to Professional Electronics Engineer (PECE) level.
I Attest that:
I am prepared to submit any document that PRC may require to support this application and
to pay whatever dues the PRC impose in connection therewith.
ENGR. ______________________
(Signature above Printed Name)
APPLICATION AND REGISTRATION FOR PROFESSIONAL
ELECTRONICS ENGINEER
(All entries must be computer printed)
1. PERSONAL DETAILS
2. EDUCATION
3. MEMBERSHIP
5. AWARDS/CITATION RECEIVED
(Attached copy of Awards/ Citation)
NAME OF COMPANY
CERTIFICATE OF EXPERIENCE
WARNING: All statements are subject to verification and any false statement or misrepresentation
made in this CERTIFICATE is a ground for disqualification and criminal prosecution.
IMPORTANT:
1. The Certifying officer should be the Personnel Officer/ Manager or Doc. No.
Equivalent Position in the office/ company. Page No.
2. This form is good only for one office/ company. Book No.
3. Certificates of Employment must accompany this certificate of Series of
Experience.
9. SIGNIFICANT ENGINEERING WORK
Company/ Office:
Address/ Location:
Direct Supervisor:
PRC License No.:
(PECE/RECE)
Applicant:
Name: Signature:
PRC License No.: Date: Valid Until:
Signature: __________________________________
Date: ____________________________________
Doc. No.
Page No.
Book No.
Series of
10. APPLICANT DECLARATION
I certify under penalty of perjury and/ or falsification of public documents that all the
documents submitted in support of this application are true copies of the authentic
original documents and that I am prepared to submit these original documents if and
when required.
I declare that the information’s given by me are accurate, correct and complete in all
relevant details to the best of my knowledge and belief.
I also declare that the relevant experience and level of Professional responsibility
claimed in the application and supporting documents provide a fair and balanced
statement, which may properly be taken into account in assessing my eligibility for
Professional Electronics Engineer.
I confirm that I have read and that I understand the Code of Professional Ethics
and Conduct of my profession and the Pledge of Electronics Engineer. I agree
that if admitted as Professional Electronics Engineer, I will observe and will be
bound by this Code of Ethics and Pledge.
I stand ready for Professional interview and to respond to any reasonable request of
the Board of Electronics Engineering for explanations or further information in
relation to my application.
Signed:
_______________________________________
(Signature of Declarant above Printed Name)
NOTARY PUBLIC
Doc. No.
Page No.
Book No.
Series of
NOTE: Guidelines for Significant Engineering Work
The specified period of the two years may have been completed in the course
of the seven (7) years’ experience.