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PHILIPPINE INSTITUTE OF CIVIL ENGINEERS, INC. Application for Elevation of PICE Members to Specialist Category ( (
) TYPE TYPE I (Recipients of Certificate Certificate of Recognition Recognition by the the Professional Professional Regulation Commission) ) TYPE II (New Applicants)
PROJECT MANAGEMENT & CONSTRUCTION ENGINEERING (PMCE) TRANSPORTATION ENGINEERING (TrE) WATER ENGINEERING (WE)
Application Code: ________
Name ___________________________________________/_________ /__________________________________________________________________ Given M.I. Surname PRC Reg. No. ______________________________ Date Reg. __________________________ Educational Attainment MS
BSCE
Date of B Birth irth __________________________________ __________________________________
School ________________________________________________________________ Year ________________
in ________________________ School ___________________________________________________________ ________________________________________________________________ _____ Year _________________
PhD in ______________________ School ________________________________________________________________ Year ________________
PICE Chapter Chapt er _______________ ________ ____________ _________ ____ Date of Regular Regular Membership Membership in PICE _____________ _______ ________
Fellow
LM Date approved:_______________ approved:__________ _____
Home Address Addr ess ________________________________________________________________________________________________________________ Tel. No. __________________________ Fax No. ______________________ Mobile No. _____________________ E-mail ________________________ Office Name/ Addr ess __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ Position _________________________ Tel. No. ______________________ Fax No. __________________ E-mail _____________________________ _____________________________ Membership in Other Professional Organizations: ___________________________________________________________________________________ ______________________________________________________________________________________________________________________________ Previous Specialist Certificates Specialty Division
No
Date of Conferment
_____________________________ ______ ___________________ _____________________________ ______ ___________________ _____________________________ ______ ___________________ REQUIREMENTS FOR ACCREDITATION OF SPECIALTY DIVISION TYPE I (__) – – NO EVALUATION . PICE Members who have been awarded a Certificate of Recognition by the Professional Regulation Commission for the specific area of specialization prior to year 2000. Specialization: __________________________ _______________________________________ _________________________ _________________________ __________________________ _____________________ ________ Date Issued : _____________________________________Resolution No. _______________________ Submitted ( ) enclose Certified True Copy of Certificate issued by PRC and ( ) most recent notarized curriculum vitae vitae with photo. TYPE II (__) – (__) – NEW APPLICANTS Compliance with the Criteria - New requirements for accreditation of specialist member: 1. All applicants must be PICE life members. 2. No Examination - Applicants with at least 15 years experience in, or with a doctoral degree in the area of specialization are not required to take a written examination but will be subject to an interview by the concerned Committee of the Specialty Division. 3. With examination 3.1 Applicants with at least 10 years experience in the area of Specialization may take the examination; OR 3.2 Applicants with at least five (5) years rated continuous continuous active practice in the area of specialization; AND at least 80 CPD (Continuing Professional Development) units, provided that not more than 30 CPD units that have been obtained before year 2000 can be credited; OR 3.3 Applicants with a master’s degree in and at least three (3) years active practice in the area of specialization •
The examination for accreditation as a specialist member will be guided by the Design Manual and/ or Syllabus to be issued as reference by the five (5) Specialty Divisions as well as seminars to be attended by the applicants.
AND: Interview at the discretion of the concerned specialty division; 4. Applicants must submit duly notarized curriculum vitae. 5. The PICE National Secretariat shall receive all applications for accreditation and is tasked to verify the authenticity of documents and information submitted. •
Submit: 1. Detailed description of practice in the specific area of specialization. Enumerate the dates/periods of engagement and provide a list of projects participated in, with corresponding description of technical service(s) rendered. (FOLLOW FORMAT ON FORM S2) 2. Proof of engagement and certified true copy of Certifications 3. Other requirements listed on Box 1.
PICE SECRETARIAT Received by: __________________________ _______________________________ _____ Date: _____________ Life Membership Validated: __________ LM No. ______ Date: _________ BOX 1 - Requirements: Payment of Accreditation Fee TYPE I PRC Certificate of Recognition Amount: ____________ Notarized Curriculum Vitae with Photo Date:_______________ TYPE II Notarized Curriculum Vitae with Photo OR No. _____________ Description of Practice following Form S2 Certificates (authenticated) Others_________ ____________ ____ Validated by:_________ ____________ ____
Endorsement of Chapter – Action of the (Submit any of the following) Secretariat: ___ Chapter Board Board Resolution ___ Minutes of Chapter Board Meeting ___ Endorsement letter signed by the Chapter President/attested President/attested by the Chapter Secretary
Validated by: __________
Action of the PICE Specialty Division: ___________________________
Action of the National Board of Directors: Approved by: ________________________ ______________________________________ ___________________________ ____________________ _______ National President
Attested by:_________________________ by:_______________________________________ ___________________________ ____________________ _______ National Secretary Date of Board Meeting: _________________________ ______________________________________ _________________________ ____________
Date: _______________________ ____________________________________ __________________________ __________________________ _________________________ ___________________ _______ Date of Examination/Interview: _________________________ ______________________________________ __________________________ _______________________ __________
AWARD PICE Certificate No. _______________ _______________ Year-Specialty Code No.________________ No.________________
Note: Please attach a photo with this form. Submit a separate separate application and documents for different specialization. Please enclose your one-time accreditation fee of Php 1,000 per application. All checks must be payable to PICE. SD Form S1-Revised May 6, 2011
