ASEAN ENGINEER APPLICATION FORM AND GUIDELINES FOR APPLICANTS (All entries must be computer printed or typewritten) FORM 1: APPLICANT’S CHECKLIST APPLICANT’S LETTER OF INTENT ADDRESSED TO THE PTC PRESIDENT PROFESSIONAL ORGANIZATION’S (APO) ENDORSEMENT SIGNED BY THE NATIONAL PRESIDENT CERTIFICATE OF GOOD STANDING FROM THE ACCREDITED NATIONAL APO & MEMBER OF PTC CERTIFICATE OF REGISTRATION VALID PROFESSIONAL IDENTIFICATION CARD COPY OF DIPLOMA (UNDERGRADUATE AND GRADUATE ENG’G) – CERTIFIED TRUE COPY CURRICULUM VITAE PERSONAL DETAILS (FORM 2) SEVEN (7) YEARS PROFESSIONAL EXPERIENCE (FORM 3) TWO (2) YEARS PROFESSIONAL EXPERIENCE (FORM 4) CONTINUING PROFESSIONAL DEVELOPMENT (FORM 5) CODE OF ETHICS (FORM 6) APPLICANT’S DECLARATION (NOTARIZED) (FORM 7) FOR PTC USE ONLY. APPLICANT NAME: EDDIE C. FUENTES APPLICANT NO. ____________________________ __ SUBMITTED BY: _________________________ ___ APPLICATION FEE LIFE REGISTRATION FEE DATE : _________________________ ___ CASH: CASH: RECEIVED BY : _________________________ ___ CHECK: CHECK: DATE : _________________________ ___ DEPOSIT: DEPOSIT: ACTIONS : OR NUMBER: OR NUMBER: DATE : _________________________ ___ DATE: DATE: Instructions: APPLICANT NAME: EDDIE CODILAN FUENTES SIGNATURE: APO/DATE: 06-08-18 1 | Page 11 Ver16.0
ASEAN ENGINEER APPLICATION FORM AND GUIDELINES FOR APPLICANTS (All entries must be computer printed or typewritten) 1. Submit three (3) sets of hard copies of all the completed application documents listed in Form 1 using A4 size white bond paper of not less than substance (80 gsm) thickness. Photocopies of large documents shall be reduced accordingly. Each set shall be submitted using a BLUE CLEAR BOOK FOLDER, COMPLETE WITH TABLE OF CONTENTS AND TABS. 2. Submit a softcopy of all the completed application documents in item 1 above and all supporting documents. Include an index file of all documents. 3. All pages of the application must be signed and dated by the applicant and shall be delivered or mailed to: Philippine Technological Council, Inc. (PTC) Rooms 405-406 National Engineering Center, Alfredo Juinio Hall, Osmeña Ave. corner F. Agoncillo St., University of the Philippines, Diliman, Quezon City. Philippines 1101. Tel/Fax no: (0632) 926-6893. 4. E-Mailed Applications or Computer-Generated Signatures on the Application Forms Will Not Be Accepted. 5. Application must be submitted together with a non-refundable Application Fee. FORM 2: PERSONAL DETAILS ASEAN ENGINEER 1. PERSONAL DETAILS Title: Prof Dr Eng Mr Mrs Ms Surname: FUENTES Given Names (in full): EDDIE Middle Name: CODILAN Date of Birth: November 5,1962 Name of Employer: Gaisano Mall of Davao Private Address (Preferred mailing address): Business Address (Preferred mailing address): 123 JUAN LUNA STREET, DAVAO CITY 8000 Gaisano Mall, Davao City Postal Code: 8000 Country: PHILIPPINES Postal Code:________Country:_______________________ Tel No. ( )______________Fax:( )_____________ Tel No. (082) 222-1411 Fax:( 082 ) 226-3507 E-mail: [email protected] Mobile No: 09228692838 / 09399132568 2.EDUCATIONAL/PROFESSIONAL QUALIFICATIONS (Use additional sheets if necessary) Academic Level Degree/Title Conferred University/College/Add ress Dates Attended: Undergraduate Master of Science and Environmental & University of Southeastern 2005=2006 APPLICANT NAME: EDDIE CODILAN FUENTES SIGNATURE: APO/DATE: 06-08-18 2 | Page 11 Ver16.0
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- Fall '18
- rayki buat
- Civil Engineering, Davao City, Provinces of the Philippines, Davao Region, Davao del Norte