Fillable Printable Engineer-In-Training Long Form Registration Application
Fillable Printable Engineer-In-Training Long Form Registration Application
Engineer-In-Training Long Form Registration Application
Questions: call (360) 664-1575
Engineer-In-Training Long Form
Registration Application
You can use this form if you are applying with a combination of education and
experience or if you are applying by experience only.
To apply for the Engineer-in-Training (EIT) exam:
• Complete this form and send the signed application (page 1) and the
Experience record summary (page 2) to: Board of Registration for
Professional Engineers and Land Surveyors, Department of Licensing,
PO Box 9025, Olympia, WA 98507
• Send the completed Experience and Verification section (pages 3-6) to the
persons verifying your experience.The persons verifying your experience will send the completed form directly to our office.
• If you want any education considered towards the requirements, request an official transcript be sent to:
Board of Registration for Professional Engineers and Land Surveyors, Department of Licensing, PO Box 9025,
Olympia, WA 98507. Photocopies are not acceptable.
• Once you have been approved for the exam, you will receive an email with information to schedule your exam.
Applicant
PRINT or TYPE Name (Last, First, Middle – will appear in the proper order on your wall certificate) Maiden name (If any – will not appear on certificate)
Social Security number required*
Date of birth (mm/dd/yyyy) Gender
Male Female
Mailing address
City State ZIP code County
Present position Business name
Business location address
City State ZIP code County
(Area code) Business telephone number (Area code) Residence telephone number Email
Answer the following
1. Have you filed an application with this office within the last five years? ......................... Yes No
If yes, date applied and application type: Engineer-in-Training Land Surveyor-in-Training
Professional Engineer Professional Land Surveyor
2. Has any court or licensing jurisdiction taken action against you for your practice in engineering
or land surveying? .................................................................. Yes No
If yes, please attach an explanation on additional sheet.
3. Have you ever been convicted of or entered a plea of guilty or nolo contendre to a misdemeanor,
gross misdemeanor, or felony? ........................................................ Yes No
If yes, please attach an explanation on additional sheet.
Name and location of colleges,
universities, technical schools attended
Dates of attendance
From To Curriculum Degree/ Date
*All applicants are required by federal and state law to provide their Social Security number (SSN) for use in child support enforcement programs (42 U.S.C.
666(a)(13) and RCW 74.20A.320). It may also be used for education loan repayment programs and identification of records with similar names. Submission
of your SSN is mandatory; failure to submit it may result in denial of your application.
I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.
Date and place Applicant signature
ENLS-651-019 (R/7/15)WA Page 1 of 6
X
Click here to START or CLEAR, then hit the TAB button
When you have completed this form, please print it out and sign here.
Experience record summary
Applicant name
Please list all of your employers below beginning with the most recent. This list is to include the entire time from
leaving college (if applicable) or beginning your engineering career to the present time. Those periods while in school,
unemployed, or non-engineering work must also be included. If not verifying, indicate “No.” Any experience not verified will
not be counted towards the experience requirement.
Verification number
Time period (begin with most recent)
From To Employer
To be verified
(yes or no)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
ENLS-651-019 (R/7/15)WA Page 2 of 6
Engineer-In-Training
Experience and Verification
Applicant experience/ verification
• Experienceisgainedunderthedirectsupervisionofaprofessionalengineer(PE).
• Applicantsworkinginthemanufacturingindustryareexemptfromgainingexperienceunderthedirectsupervisionofa
professional engineer, but a PE must be employed by the firm. If this is the case, indicate the name and license number
of the PE at the time of your employment. Your direct supervisor verifies your experience.
Name and license number of the PE:
• Ifemployedbythefederalgovernment,youarenotrequiredtogainexperienceunderaprofessionalengineer.Your
direct supervisor verifies your experience.
Instructions for applicant
Send this completed Experience and Verification section (pages 3-6) to the persons verifying your work experience.
Additional sheets may be attached if needed, but please identify the categories (A-H) you are describing. You may make
photocopies of this form for additional experience verification.
Work experience information – applicant complete this section
Applicant name Verification number (from page 2)
Employed by
Job title Dates of employment
From To
Average hours per week
Supervisor name and title (Area code) Telephone number
Supervisor business address
City State ZIP code
Work experience descriptions – applicant complete this section
This experience is broken down into eight categories (A-H) for each event. Describe experience (one line is not
sufficient) detailing the work you personally performed. This work should be progressive in difficulty and magnitude;
demonstrate sufficient breadth and scope, and reflect the acquired ability to design and apply engineering principles to
demonstrate that your judgment may be trusted on projects involving public health and safety. Attach separate sheets if
necessary.
Describe your experience
A. Preparation of technical reports and specifications, including graphics.
B. Application of mathematical techniques to problem solving.
ENLS-651-019 (R/7/15)WA Page 3 of 6
Applicant name Verification number
Work experience descriptions – continued
Describe your experience
C. Application of the basic physical sciences (chemistry, dynamics, statics, physics, etc.) in tasks.
D. Performing assignments, experiments, and tests to general specifications.
E. Compilation and interpretation of data (statistical analysis, etc.).
F. Executing complex engineering tasks according to instructions.
G. Effective communication with associates and presenting recommendations and conclusions to supervisor.
H. Knowledge of impacts of the products of technology on society (energy/ environmental considerations).
ENLS-651-019 (R/7/15)WA Page 4 of 6
Applicant name Verification number
Verification instructions
After completing your verification, return this Experience and Verification section (pages 3-6) to:
Board of Registration for Professional Engineers and Land Surveyors
Department of Licensing
PO Box 9025
Olympia, WA 98507
Work experience verification – supervisor/verifier complete this section. All sections must be completed.
Answer the following
If you are not the applicant’s supervisor, please explain your working relationship to the applicant and how you are able
to provide this verification:
If you are not a licensed professional engineer, under what authority are you verifying experience? (federal agency,
exempt corporation, etc.) Years of engineering experience you have
Please describe your level of supervision over this applicant.
State your opinion regarding the accuracy of the applicant’s employment time, hours worked, and descriptions of
experience (categories A-H), including the scope and complexity of the work described.
During this time of employment, how long has the applicant been in a position of making engineering judgments and
decisions?
years/months. Give a brief description of a typical project for which the applicant made
independent judgments and decisions, and the character of the duties required by the project.
Please explain why you think this individual is suited for licensure.
RCW 18.43.040 states that no person shall be eligible for registration as an engineer-in-training who is not of good
character and reputation. Please comment on the applicant’s character, personal and professional reputation:
ENLS-651-019 (R/7/15)WA Page 5 of 6
Professional
Engineer
stamp or seal
X
Applicant name Verification number
Work experience verification – continued
Were you registered as a professional engineer at the time you supervised the applicant? ............ Yes No
PRINT or TYPE Verifier’s name Title
Address
City State ZIP code
(Area code) Telephone number Email address
License number License state Issue date Expiration date
I certify that the statements and answers contained in this verification regarding the person named as applicant are true
and correct to the best of my knowledge.
Date and place Verifier’s signature
Please affix your stamp or seal in the space provided.
If no seal or stamp is available, you may attach a copy of your current license.
EN-651-019 (R/7/15)WA Page 6 of 6
When you have completed this form, please print it out and sign here.
