Fillable Professional Engineer Reference Form (Page 2 of 3) in pdf

You may be requested to substantiate any statements made herein.

(

This form should not be filled out in the presence of the applicant. Please print clearly.)

tatemeNt of

NdoRSeR

1. a. How many years have you known the applicant on a personal basis? __________________________________

b. How many years have you known the applicant in your professional capacity? _ _________________________

2. How would you characterize the applicant’s character and personal reputation?

Excellent

Good

Unacceptable

Not known

If “Unacceptable,” please explain: _______________________________________________________________

__________________________________________________________________________________________

3. You are the applicant’s: Manager/Director Direct Supervisor Co-worker/Colleague Subordinate

Other ___________________________________________________________________________________

4. Is your knowledge of the applicant’s engineering experience based exclusively on your relationship described in

question three? Yes No

If “No,” please indicate the basis of your knowledge: ________________________________________________

__________________________________________________________________________________________

5. Please comment on the applicant’s ability to effectively communicate, both verbally and in writing, in the English

language.

__________________________________________________________________________________________

6. Please comment on the applicant’s knowledge and application of engineering principles. _ ___________________

__________________________________________________________________________________________

7. Please comment on the applicant’s development of engineering judgment and work accuracy. _ _______________

__________________________________________________________________________________________

8. Please comment on the applicant’s ability to assume responsibility and direct people. ______________________

__________________________________________________________________________________________

9. Please comment on the applicant’s ability to recognize and work within his or her own limitations. ___________

__________________________________________________________________________________________

Professional Engineer Reference Form Page 2