Instructions for Completing Professional Experience Forms

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Note: The Department will not accept professional experience endorsed by the applicant. Share these instructions with each endorser completing a Form 4A.

Introduction

These instructions are intended to assist the applicant and the qualified professional who intends to serve as the endorser validating the applicant’s professional experience to meet the requirements for licensure as a professional engineer in New York State. If there are any questions about these guidelines, or any other aspect of licensure, please feel free to submit a Contact Us Form or contact the State Board for Engineering and Land Surveying at engineer@nysed.gov or call 518-474-3817, ext. 140 or write to:

The New York State Education Department
Office of the Professions
State Board for Engineering, Land Surveying and Geology
89 Washington Avenue
Albany, New York 12234-1000.

Both the applicant and the endorser should read and be thoroughly familiar with these instructions. The form used to list professional experience Professional Engineering Form 4 - Report of Professional Experience requires a comprehensive listing of all endorsers and places of employment where the applicant gained his/her professional experience as an engineer.

Form 4

You must complete Form 4 and submit it to the State Education Department at the address at the end of the form. Indicate the discipline that most closely relates to the majority of your professional experience being submitted for evaluation. List all experience that you wish to be evaluated for licensure. Your experience must be listed in chronological order beginning with your first employment for which experience is being claimed, and include firm name, name of endorser, beginning and ending dates, and total time claimed for each endorser. Be sure to sign and date the attestation in item No. 6.

The Department will not accept professional experience endorsed by the applicant. Your experience must be endorsed by someone who is familiar with your work and can attest that it has been done as stated and is accurately described. Your endorser should preferably be the person who was your supervisor at the time the work was performed. If you are unable to obtain a supervisor's endorsement, select another person (coworker or client) you worked with who is sufficiently knowledgeable about your work to attest to the accuracy of your experience description.

When an endorsement does not lend credibility to your experience, it may be discounted at the judgement of the Board. A Form 4A that is not endorsed will not receive any credit toward licensure.

Form 4A

Complete Sections I and II and send this form to your endorser to complete Section III. The Department will not accept professional experience endorsed by the applicant. Upon completion, your endorser must return the form directly to the State Education Department in a sealed envelope.