Professional Engineering & Land Surveying
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Instructions for Completing Professional Experience
Forms
Note: 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 contact the
Office of the Professions, Professional Engineering Unit at
opunit1@mail.nysed.gov or
call 518-474-3817 ext. 250 or contact the State Board for
Engineering and Land Surveying at enginbd@mail.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 and Land Surveying
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 (Form 4)
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.
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 this is not possible, a letter documenting the
reasons, must be provided with the Form. 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. Upon completion, your endorser must
return the form directly to the State Education Department in a
sealed official envelope.
- Section I
- Complete Form 4A for each endorser listed on Form 4.
- Use a separate Form 4A for each endorser, even if they work
for the same company.
- If you worked for the same company more than once, with other
employment interrupting that work period, you must use a separate
Form for each period you worked for the same company, even if
they are to be endorsed by the same person. This is required in
order that your experience can be arranged in chronological
order.
- For each Form 4A, in item No. 6 you must indicate the
duration of your experience with that endorser, whether your
experience was full time or part time, and if part time the
number of hours worked each week. Time claimed must match that
claimed on Form 4 and cannot exceed calendar time. The Department
will not process your application, if the time claimed for each
endorser on forms 4 and 4A is not consistent.
- Section II
- Part A should be a concise description of your overall
engineering duties. This section should be written in general
terms.
- Part B should be a brief description of your level of
responsibility for the work performed for the experience being
reported for the endorser. You should indicate your title and any
title changes resulting from promotions or other job changes
during the time period described.
- Part C should contain a detailed description of the
engineering work you personally performed during the time period
claimed for the endorser. When writing the description of your
experience, be specific about your personal engineering
contributions to the project and describe your work in sufficient
detail to give the Board a sense of the complexity and breadth
and depth of your work. To accomplish this, the description of
your experience should be broken down into intervals of no more
than two years. Please note: the description of your work
experience should avoid generalities such as “involved
with” or “participated in” and focus on your
individual contributions.
- Indicate the duration or your work experience in the
“Time” (years/months) column, and complete the totals
at the bottom of each page of Form 4A.
- Whether or not your work experience is accepted toward
fulfillment of state licensure requirements is determined, in
part, by the extent to which the general characteristics of that
work conform with the criteria established by the Regulations of
the Education Commissioner, in Part
68.2. For a print copy of the Commissioner’s
Regulations, email opforms@mail.nysed.gov or
call 518-474-3817 ext. 320.
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