COMPUTER ENGINEERING

CERTIFICATION BOARD (CpECB)

Certified Computer Engineer (CCpE)
Application Form

Data Privacy Consent: I understand and agree that by filling out this form, I am
allowing the Computer Engineering Certification Board to collect, process, use,
share, and disclose my personal information for my application for Certified
Computer Engineer. Also, to store it as long as necessary for the fulfillment of the
stated purpose and following applicable laws, including the Data Privacy Act of
2012 and its Implementing Rules and Regulations, and the CpECB Data Privacy
Policy.

Instructions:

1. Fill out this form carefully and electronically

2. Attach a passport size current picture with white background on the top right-hand corner of
this form.
3. Only application forms properly accomplished and submitted with the complete requirements
will be processed by CpECB.
LAST NAME FIRST NAME MIDDLE NAME
DANGAN MARIA ANA GUEVARRA
SEX: CITIZENSHIP: CIVIL STATUS: (dd/mm/yyyy)
FEMALE FILIPINO MARRIED 02/26/1993
PERMANENT MAILING ADDRESS
3002
0179 PUROK 6 MERCADO HAGONOY BULACAN
PLACE OF BIRTH
09778162229
HAGONOY BULACAN GUEVARRAMARIAANAP@GMAIL.COM

PERSONAL DATA

EDUCATIONAL BACKGROUND - SCHOOLS ATTENDED

Date of
COLLEGE/UNIVERSITY DEGREE ADDRESS
Graduation
BULACAN STATE CITY OF MALOLOS,
TERTIARY BSCPE 2014
UNIVERSITY BULACAN
GRADUATE
SCHOOL MAPUA UNIVERSITY MSCPE INTRAMUROS, MANILA ON-GOING

EMPLOYMENT HISTORY (From the latest)

COMPANY INCLUSIVE
POSITION NATURE OF WORK
DATES
BULACAN STATE INSTRUCTOR I EDUCATION 2015-
UNIVERSITY PRESENT

ACCENTURE, INC. ASSOCIATE SOFTWARE ENGINEER 2014 -

SOFTWARE 2015
ENGINEER

REFERENCES
CONTACT
NAME POSITION ADDRESS
NUMBER
MA. MAGDALENA V. COLLEGE DEAN GUIGUINTO, BULACAN 0923 303 3439
GATDULA
MONALIZA S. JIMENEZ DEPARTMENT CITY OF MALOLOS, 0932 875 2105
HEAD BULACAN

RICHARD Y. DELA CRUZ COLLEGE PLARIDEL, BULACAN 0917 335 2125

SECRETARY

SPECIMEN SIGNATURE (Use black permanent marker ONLY)

I certify that the foregoing statements and the attached documents are true and correct. I am
fully aware that any false or misleading statements on this form or the attachments will be grounds for
the disqualification for Certification.

_______MARIA ANA G. DANGAN______

SIGNATURE OVER PRINTED NAME

_03/30/2022_

Important: Credentials filed in support of this application become the property of the
Computer Engineering Certification Board and will not be returned to the applicant.

Payment Instruction:
1. Payment of Application fee should be through bank deposit or bank transfer only.
 2. Account Name: Computer Engineering Certification Board
3. Account Number: 166070006103
4. Branch: PNB UE Recto

Submission of Documents:
1. Follow instruction on submission of document or evidences given in Section H of the
Implementing Certification Guidelines ICG).
2. email documents to gfr.application@cpecb.org.ph
Appendix 2

COMPUTER ENGINEERING CERTIFICATION

BOARD
(CpECB)
Rundown of Accumulated Score Form
Name of Applicant (LN, FN, MI)

DANGAN, MARIA ANA G. 03/30/2022 GUEVARRAMAARIAANA

P@GMAIL.COM
Address
09778162229
0179 PUROK 6 MERCADO HAGONOY BULACAN 3002

Self- CpECB
Criteria/Activity Document
Score Score
I. Educational BSCpE - Diploma 50
Qualification

Associate Software Engineer 20

II. Work Experience and
Faculty Member 10
Professional Services

As Regional Board Member 8

III. Involvement in
Professional As a Lifetime Member 20
Organization
As a Regular Member 3

I
IV. Participation in ICpEP
Events

V. Technical/Research
Activities

VI. Community Sambalaran 20

Outreach / Extension
 Activities
TOTAL SCORE
NOTE:
1. Accomplish this form electronically and accurately
2. Add rows as needed
 COMPUTER ENGINEERING CERTIFICATION
BOARD
(CpECB)

Checklist of Requirement Form

Name of Applicant (LN, FN, MI)
GUEVARRAMARIA
DANGAN, MARIA ANA G. ANAP@
03/30/2022
GMAIL.COM
Address 09778162229
0179 PUROK 6 MERCADO HAGONOY BULACAN

For Secretariat Use Only

Please check the box if you have accomplished the requirement.
  Cover Letter
  Application form
  Personal details
  Education
  Photocopy of ICpEP Membership Certificate / ID
  Professional Experience
Significant Computer Engineering WorkSummary of Activities Claimed as
 
Continuing Professional Education
  Authenticated Digital of Copy of Diploma
Digital of Official Transcript of Records
  Digital copy of NBI Clearance
  Digital copy of PSA Birth Certificate and Marriage Certificate (if applicable)
Recent passport size photographs with white background and with name tag
 
(coat & tie for men)
  Application Letter
Photocopy/digital copy of PRC Issued Registered/Professional Engineer
License if applicable
  Digital copy Bank Deposit slip
Note:
1. The accomplished application form, including copies of all supporting documents, shall be
submitted in A4 –size (210 mm x 297 mm) of paper not less than substance 20 (80 gms)
thickness shall be used throughout; photocopies of large documents shall be reduced
accordingly.
2. All applications shall be originally-signed by the applicant and shall be delivered or mailed to
CpECB Office
Appendix 4

COMPUTER ENGINEERING CERTIFICATION

BOARD
(CpECB)

CCpE Application Letter

Date__March 30, 2022__

Enrgr. Noel B. Linsangan

Chairperson, CPECB

Dear Sir/Madam:

I have the honor to apply herewith for the Certified Computer Engineer (CCpE) through
the Grandfather’s Rule.

I Attest that:

1. I finished the degree of Computer Engineering here in the Philippines.

2. I have been practicing the profession for at least one (1) year.

3. I am a member in good standing of the Institute of Computer Engineers of the

Philippines, Inc. (ICpEP), with ICpEP Membership No. R3-2020-0007 valid
until __lifetime__.

4. I am not convicted with finality by the court of an offense involving moral

turpitude.
I am willing to submit any document that CpECB may require to support this application and
to pay whatever dues the CpECB impose in connection therewith.

Thank you for your kind attention.

Very truly yours,

Maria Ana G. Dangan

Name /Signature
Appendix 5

COMPUTER ENGINEERING CERTIFICATION

BOARD
(CpECB)

Board’s Approval Form

Name of Applicant (LN, FN, MI)
GUEVARRAMARIAA
DANGAN, MARIA ANA G. NAP@ GMAIL.COM
03/30/2022
Address 09778162229
0179 PUROK 6 MERCADO HAGONOY BULACAN

For CpECB Use Only:

Decision Name and Signature Date
(Approved/Disapproved)

Desiderio R. Apag III

Member

Policarpio D. Tena II
Member

Lorenzo B. Sta. Maria

Member

Erwin G. Mendoza
Member

Noel B. Linsangan
Chairman

CpECB Final Decision

Noel B. Linsangan
Chairman