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Fe Re Exam App 093013
Fe Re Exam App 093013
Fe Re Exam App 093013
Professional Engineers
2639 North Monroe Street, Suite B-112
Tallahassee, FL 32303
Fundamentals of Engineering
Re-Examination Application
APPLICATION INSTRUCTIONS:
Applications received after the scheduled deadlines will be processed for the following scheduled exam date.
It is recommended that you mail your application at least ten 1(10) days prior to the application date.
As you begin this application process you will receive updates on your application.
30 Day Notice of Status - You may also check the status of your application by visiting our web site and
selecting the search link to myfloridalicense.com. If you have not received a status on your application as the
completion date approaches, please contact our office by e-mail or phone.
Notice of Approval - Once you receive your Notice of Approval email from the Board, you must register with
NCEES at www.ncees.org to complete the examination process.
Notice of Denial - If you should receive a Notice of Denial, you will be advised of your right to appeal under
Chapter 120, F.S.
If you have any questions concerning Licensure by Examination, please contact our office.
To be completed by FBPE
File #:
Application #:
$30 Received:
1. APPLICANT PROFILE DATA:
Name
Last
Mailing
Address
Middle
Apt /lot #
City
County
State
Zip Code
NO If YES, please attach a copy of the marriage certificate or legal court order.
Have you ever been convicted or found guilty, or entered a plea of guilty or nolo contendre regardless of adjudication, of a crime in any jurisdiction, or
have you ever been found guilty by a military court-martial? (Do not include pending charges or non-criminal traffic violations.) YES
NO
If YES, please list date, jurisdiction (state & county), offense, disposition and all other relevant information on attached sheet(s).
We are required to ask that you furnish the following information as part of your voluntary compliance with Section 2, Uniform Guidelines on
Employee Selection Procedure (1978) 43FR38296 (August 25, 1978). This information is gathered for statistical and reporting purposes only and
does not in any way affect your candidacy for licensure.
Race:
Caucasian
Other:
African-American
Hispanic
Asian
YES
NO
Native American
Sex:
Male
Female
2. EDUCATION:
Type of
Degree
Received:
Did you
graduate
Y/N
Month/Day/Year
In what discipline of
engineering was or will
your degree be issued?
/
/
/
YES
NO
If yes, list the date of the last Engineer Intern Examination you have taken or were scheduled for:
4. AFFIRMATION
I have carefully read the questions in the foregoing application and have answered them completely, without reservations of any kind,
and I declare and affirm that my answers and all statements made by me herein are true and correct. Should I furnish any false
information in this application, I hereby agree that such act shall constitute cause for the denial, suspension, or revocation of any
license to practice in the State of Florida for the profession for which I am applying.
Applicant
Sign Here ____________________________________________________
Date__________________________
__
__
Date: _____________________
______________________________________
Date
(SCHOOL SEAL)
__
__
Telephone #:
Social Security No.:
Date of Attendance:
Degree Awarded:
Discipline:
I am making application to the Florida Board of Professional Engineers for Fundamentals of Engineering
Examination and subsequent certification as an Engineer Intern. Please forward this document, along with an
official copy of my transcript, to the Florida Board of Professional Engineers, 2639 N. Monroe Street, Suite B112, Tallahassee, Florida 32303. If there is a fee to release the requested transcript, please contact me
immediately.
Date: ______________________
(SCHOOL SEAL)