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PSME Maintenance Professional L 1 Cert Attachments Rev 1 22 Aug 2023
PSME Maintenance Professional L 1 Cert Attachments Rev 1 22 Aug 2023
Contact Information
Home Phone Mobile No Email Address
2.0 PROFESSIONAL INFORMATION
Current Job Position Title
Employment Date Years in Service
Company / Organization Name
Business Address
Business Email Address
3.0 EDUCATIONAL INFO. Institution/School Name From/To Year
Educational Attainment
Undergraduate/Technical Vocational
College Degree
Master’s Degree
Others
4.0 PROF. LICENSE (if any) Registration Issuance Date Validity Date
Certified Plant Mechanic (CPM)
Registered Mechanical Engr. (RME)
Professional Mechanical Engr. (PME)
Other License
5.0 TRAINING and SEMINARS (may attach separate sheet)
Name Trainings/Seminars Provider Date Total Hours
6.0 PROFESSIONAL AND WORK EXPERIENCE (start from latest employment)
Position Title
Company/Organization From/To Total Years
Job Function
Name
Last Name Middle Name First Name
Remarks
Signature Date(mm/dd/yyyy)
PSME Certification Committee
Received Date (mm/dd/yyyy)
Name
Last Name Middle Name First Name
Remarks
Signature Date(mm/dd/yyyy)
Date Endorser’s Endorser’s
Applicant Recommended for: (mm/dd/yyyy) Name Signature
Form C2: CMP Level 1 Application Checklist
(For TD / Certification Committee / Applicant’s Use)
Application Checklist
Application Date: (mm/dd/yyyy)
Applicant’s Name:
Last Name Middle Name First Name
Applicant’s Signature
REQUIREMENTS Submitted Remarks
1.0 Application Form
2.0 Education Diploma / Certificate
3.0 Professional License Documents
4.0 Trainings and Seminars Documents
5.0 Certificate of Employment from latest employer
6.0 Letter of Recommendation from immediate superior/company
7.0 Trainings and Seminars Total Hours
7.1 Trainings / Seminars Attended Completed Remarks
(a) Maintenance Concept and Current Trends
(b) Application of Maintenance Concepts in Industry
(c) Critical Equipment Maintenance & Strategy
(d) Preventive and Predictive Maintenance
(e) Maint. Quality Mgt. and the Applicable Standards
(f) Maintenance Management & Strategy
(g) Maint. Performance Metrics, Benchmarking & Best Practices
(h) Computerized Maint. Management System (CMMS)
(i) The Environment, Health, & Safety (EHS) Management and
Standards in relation to Maintenance
(j) Inspection/NDT as aid & tool for maintenance works
Total Hours
7.2 Leadership and Management Training Completed Remarks
(a) Comm. (Oral/Written), Presentation & Facilitation Skills
(b) Interpersonal & Team Skills, Stakeholder Engagement
(c) Problem Solving & Decision Making
(d) Coaching and Mentoring Skills
(e) Risk Management Skills
(f) Project Management Skills
(g) Budgeting & Financial Planning
(h) Strategic and Business Management Skills
Total Hours
8.0 SKILLS AND COMPETENCIES PEM TD Body of Knowledge (BoK)
8.1 Building Block 1: Work Management Complied Remarks
(a) Plan and Schedule Work
(b) Execute and Document Work
(c) Utilize information technologies effectively
(d) Identify, validate, and approve, and prioritize work
(e) Analyze work and follow-up
(f) Measure work management performance
(g) Plan and execute project work
(h) Manage resources and materials
8.2 Building Block 2: Process Improvement Complied Remarks
(a) Understand applicable processes
(b) Apply process improvement techniques
(c) Maintain processes in accordance with applicable codes &
standards
(d) Manage effects of changes to processes and equipment
8.3 Building Block 3: Maint. Org. & Leadership Complied Remarks
(a) Lead and manage people
(b) Determine organizational needs
(c) Analyze organizational capability
8.4 Building Block 4: Strategic Maintenance Mgt. Complied Remarks
(a) Develop Strategic Maintenance Program
(b) Determine Maint. Performance and Improvement
(c) Create Maintenance Management Plan
(d) Select and justify identified maintenance plans and implement
(e) Manage Maintenance Organizational Plan
(f) Manage EHS hazards and risks
9.0 CONTINUING PROFESSIONAL DEV’T (CPD) Complied Remarks
(1) Maintenance Professional Practice
(2) Professional Development
(3) Social Responsibility
10.0 REQUIREMENTS FOR CERTIFICATION UPGRADE Complied Remarks
(1) CMP Certification Level
(2) Advance Maintenance Trainings and Seminars
To be filled up by PSME CMP Certification Committee
Remarks
Form C3: Endorsement Letter
Applicant Endorsement Letter
WARNING: All statements are subject to verification and any false statement or misrepresentation
made in this CERTIFICATION is a ground for disqualification and criminal prosecution for falsification.
1
2
3
Name/Signature/Date (mm/dd/yyyy)
Affiant (Certifying Officer)
IMPORTANT:
1. This form is good only for one supervisor. use another sheet for experience/s under other supervisor/s
2. Certificate of Employment must accompany this Certificate of Experience.