Académique Documents
Professionnel Documents
Culture Documents
Registration of
Senior Professional Engineer (Sr. PE)
APPLICATION FORM
Serial No. ______________
1.
Personal Particulars
1.1 Name (In Capital Letters)
Paste Latest
Passport size
Photograph
1.3 Male
1.4 Single
Female
Married
Other
1.5: Present Organisation/ Work Place Name and Address with Pin code:
Fax
___________________________________________
E-mail: mangaloreshenoy@yahoo.com
1.6 Residential Address
mangaloreshenoy@yahoo.com
Organisation Address
2.
Engineering
Qualifications
Institute/University
Disciplines/Major Subjects
Year of
Completion
B. Tech
M.Tech
PhD
University of Calicut
NITK, Surathkal
NITK, Surathkal
Civil Engineering
Structures
Civil Engg (Structures)
1985
1987
2016
3.
Engineering
Qualifications
Institute/University
Disciplines/Major Subjects
Year of
Completion
Diploma
National Insti. Of
Lab. Edn & mgmt
NSS College of
Engineering, Univ. of
Calicut
NITK Surathkal
Industrial Safety
1998
Certificate
Certificate
Computer Programing
in BASIC
1986
4.
Name and Category of Membership in Engineering related Professional Institutions / Associations/
Societies
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
Fellow
Life Member
Life Member
Life Member
Life Member
Life Member
Corporate Mem
Life Member
Life Member
Life Membership
Life Membership
Life Membership
Life Membership
Life Membership
Life Membership
Life Membership
Life Membership
Life Membership
5. Continuous Professional Development Programme / Activities since engineering graduation or last six years
(whichever is less) (Details of eligible CPD activities available on ECI web site www.ecindia.org)
I.
II.
5.1
Recognised Training Programme, Conferences, Seminar, Workshop, Technical Presentations Attended /
Participated
Title / Subject
Duration
Nature of Participation
Conducting Organisation
Computer Applications in
Civil Engineering
Computer Applications in
Structural Engineering
ISTE Summer School of
Database Management
Systems
Winter School on
Environemental Sciences
Structural Engineers
World Congress
Seminar on Foundation
for Multi-storeyed
Buildings
Supervisory
Development
Programme
Many Workshops
conducted by
Government Bodies , like
Earthquake Resistant
Design
15 days
KREC-NITK Surathkal
15 days
Co-ordinator, Resource
Person
Co-ordinator, Resource
Person
Participant
15 days
Participant
KREC-NITK Surathkal
6 days
Participant
SEWC
1 day
Participant
6 days
Participant
7 days, 15 days,
Lectures, Resource
Person, Participant
District Administration,
Govt. Colleges, Private
Institutions
Continuing Education
Programs for Practising
Civil Engineers
Continuing Education
Program on Internet,
Intranet & Programming
Practical Training on
Structural Engineering
Awareness Program in
Steel Construction
Basic Military Training
Military Engineering 2nd
Lt
15 days
Co-ordinator and
Resource Person
KREC-NITK
Surathkal,
28 days
Participant
KREC-NITK Surathkal
48 days
Intern
FEDO, Cochin
2 days
Participant
INSDAG
60 days
60 days
Officer Cadet
-Commissioned
15 days
KREC-NITK Surathkal
KREC-NITK Surathkal
5.2
II.
III.
IV.
II.
6.
Professional Experience
Describe your experience in the following format, for each period of your employment / involvement in
retrospective order i.e. starting from present position in descending sequence. If self-employed, write self-employed
under Position, and give details of experience. Please also underline the experience in a responsible position of
significant engineering activity.
From
1996
to
Continuing
1987
1996
Position
Founder Partner &
Chief Consultant ,
Self Employed
Lecturer in Civil
Engineering
Organisation
Roy & Shenoy
(ISO 9001)
NITK
Surathkal
Brief Description
Providing Professional Consultancy Services
& Training in the field of Civil, Structural,
Project Management , Techno legal Areas.
Handling UG & PG Lecturers, Laboratories,
Participating in Consultancy Services
Civil Engineering
8.
State Field of your Specialisation(s)
Specify discipline of specialisation(s) and its sub-discipline, under which you would like to be registered. A
note outlining justification is to be attached.
dated
Bank
i) Fee: The initial registration fee will be Rs. 3000 for PE, Rs. 2000 for APE, Rs 2000 for G.E, Rs 2000 for
Dip.E, Rs 2000 for B.Voc. E, Rs 1000 for SE. The fee structure is subject to change in future. The
registration is subject to renewal after 5 years.
(Note:- Service Tax (at present 14.5%) is extra, and needs to be added to the Registration Fee payable)
ii) The fee is non-refundable.
10) Declaration:
I agree to abide by, the professional Code of Ethics established by Engineering Council of India,
and to be held individually accountable for my action.
I undertake to send reports of Professional Experience and Continuing Professional Development
as on 31st March of each following year regularly so as to reach ECI by 30th June.
I agree that decision of the ECI on Registration and Termination shall be binding on me.
I hereby confirm that the contents of the items described in this application documents are true and
correct.
Enclosures:
1.
2.
3.
4.
5.
11. I am known to the following two referees (engineers):1) Name :- Dr. T P Somasundaran,
Address :- Professor in Civil Engineering, NIT Calicut, Chathamangalam PO , Calicut, Kerala
Contact Details:- Email:-tps@nitc.ac.in
Telephone No.:Mobile No.:- +919447117929
Knows since (Period):- 1983
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