California Geotechnical Engineering

BOARD OF EXAMINERS Examination Pre-Registration Form

FOR ENGINEERING &
Instructions
LAND SURVEYING
670 Hawthorne Avenue, SE tel. 503.362.2666
Suite 220 email: osbeels.info@oregon.gov
Salem, Oregon 97301 Web: oregon.gov/osbeels

California Geotechnical Engineering Examination Pre-Registration Form

Instructions for Filling Out the California Geotechnical
Engineering Examination Pre-Registration Form

The following instructions are provided to assist in

completing the form.

PLEASE READ the applicable Oregon Revised Statutes intending to examine for the next available California
(ORSs) and the Oregon Administrative Rules (OARs). To Geotechnical Engineering
locate the ORSs and the OARs, visit our website at of
www.oregon.gov/osbeels. Click on the for registration.
“Rules & Statutes” link in the top bar to review
the relevant ORSs and OARs.

It is the Applicant’s responsibility to review the qualification requirements before applying to the Board for registration.

an exam candidate must:

• Complete a pre-registration form; and

• Submit a check or money order to the OSBEELS in the amount of $150.00,

payable to “California Board for Professional Engineers, Land Surveyors, and Geologists.”

State of California, but is available at Oregon test sites. Consult the California Board for Professional Engineers,
Land Surveyors, and Geologists for examination dates, times, test site locations, cost, and details.

See the following OAR for detailed information: OAR 820-010-1010.

Oregon State Board of Examiners for Engineering and Land Surveying tel. 503.362.2666
form CA Geotech Pre-Registration, updated 11/30/2017 email: osbeels.info@oregon.gov
 Date Entered/Paid:
BOARD OF EXAMINERS
FOR ENGINEERING &
LAND SURVEYING
670 Hawthorne Avenue, SE tel. 503.362.2666
Suite 220 email: osbeels.info@oregon.gov
Salem, Oregon 97301 Web: www.oregon.gov/osbeels

California Geotechnical Engineering Examination Pre-Registration Form

Applicant Information
First name (personal name) Middle name or initial Last name (family name)

Birth date (Month/Day/Year) Where do you want correspondence mailed to?

 Home address OR  Business address
Home address (include any apartment number) Home/Personal phone #

City State or Province Zip/Postal code Home email address

Business name Business phone # Business fax #

Business address (include any suite number)

City State or Province Zip/Postal code Business email address

Address for public disclosure (As per Oregon Revised Statute (ORS) Chapter 192)  Same as mailing address

City State Zip Email address

Signature and authorization

Signature Date (Month/Day/Year)

Please enclose a check or money order to the OSBEELS in the amount of $150.00,
payable to “California Board for Professional Engineers, Land Surveyors, and Geologists.” (see OAR 820-010-1010)

Oregon State Board of Examiners for Engineering and Land Surveying tel. 503.362.2666
form CA Geotech Pre-Registration, updated 11/30/2017 email: osbeels.info@oregon.gov