Please Affix
Reg. No. _____________
Recent Photo
Application Form
APEC Engineer
1. Personal Information (as shown on passport)
First Name _____________________________ Middle Name ____________________________ Last Name ____________________________
Gender Male Female Nationality ________________________ Date of Birth (DD/MM/YYYY) _________________________
Citizen ID _______________________________ Passport No. ______________________________ Passport expiry date _________________
Contact Address ________________________________________________________________________________________________________
Province _________________________________ Postcode ___________________________ Mobile No. _______________________________
Tel: _________________________ Fax: _________________________ E-mail: _____________________________________________________
2. Professional Information
Associate Engineer License No. (Discipline) ______________________ Issued date _________________ Expiry date _________________
Current PE License No. (Discipline) ______________________________ Issued date _________________ Expiry date _________________
Present Company Name _________________________________________________________________________________________________
Company Address ______________________________________________________________________________________________________
Province _____________________________________ Postcode _______________________________ Tel: _____________________________
Fax: _________________________ E-mail: ___________________________________________________________________________________
3. Engineering Education
Undergraduate Degree _______________________________________________ University/Institute _________________________________
Year of graduation ___________________________ Discipline of Engineering ____________________________________________________
Post Graduate Degree ________________________________________________ University/Institute ___________________ ______________
Year of graduation ___________________________ Discipline of Engineering ____________________________________________________
4. Discipline for APEC Engineer Regulation 5. Responsible Charge/ Expertise
(Please mark only one discipline which you desire to register as an APEC Engineer) (Can be more than one if applicable)
Civil Mining Consultancy Analysis and Design
Mechanical Electrical Project Planning Engineering Supervision
Industrial Chemical Investigation
Environmental Other ________________ Operation and Maintenance
I, the undersigned, apply for the registration as APEC Engineer through the Thailand Monitoring Committee and declare as follows;
(a) I confirm that all the information I have given in APEC Engineer application form and the enclosed certificates are true.
(b) I shall be bound by the Professional Engineer Act and the Professional Engineer (Code of Professional Conduct and Ethics) Rules
established and enforced by the Council of Engineers, Thailand.
(c) I shall be bound by the APEC Engineer Agreement and other relevant commitments in the future.
____________________ ____________________________
Date Signature of Applicant
Reg. No. _________________
Professional Experience
Detailed Description of Engineering Work
(Please describe the contents and significance of the work, the applicant’s role, and the degree of
the applicant's responsibilities about 50 words.)
Work Starting Date- Position and Project Owners/
No. Ending Date Name of Clients Details of Engineering Work
(months) Organizations
Sum of Experience Years /Months
Note: The professional experience should be referred to professional practices record
Reg. No. _________________
Professional Practices Record
Engineering Work Experience
(Please describe in retrospective order, beginning with the most recent one.) Attesting Witnesses’ Column
Work Name of Project Owners/ Starting Date
No. Organizations Clients Ending Date Professional Practices Duty/ Scope of Work Outcome/ Performance Signature Remark
(Position/Title) (months)
Sum of Experience in responsible Charge of Significant Engineering work Months /Years
Note: 1. The applicant has spent 2 years in responsible charge of significant engineering works.
2. The signor(s) above shall be, in principle, the applicant’s direct supervisor(s) or any professional engineer/senior engineer under the applicant has executed his engineering works.
Reg. No. _________________
Monitoring Committee Summary
APEC Engineer
Name of Applicant _____________________________________________________________________________
PE License/Certificate No. __________________________________________ Issued by Council of Engineers
Issued date (DD/MM/YYYY) _______________________ Expiry date (DD/MM/YYYY) _____________________
Thailand Registered Engineer Registration No. ______________________ Issued date ___________________
Thailand Registered Engineer’s Discipline _________________________________________________________
APEC Engineer Discipline _______________________________________________________________________
Certified Compliance with APEC Engineer Criteria
Completed an accredited or recognised engineering program, or assessed recognized equivalent
Been assessed within their own country as eligible for independent practice
Gained a minimum of seven years practical experience since graduation
Spent at least two years in responsible charge of significant engineering work
Confirmed signature on statement of compliance with codes of ethics
Signed
(__________________________) (__________________________)
Delegated Chairman
Monitoring Committee (Thailand) Monitoring Committee (Thailand)
Date ________________________ Date ________________________
