State Form 49856 - Supplemental Information For Land Surveyar & Land Surveying Intern Application - Indiana
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1SUPPLEMENTAL INFORMATION FOR LAND SURVEYOR &
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LAND SURVEYING INTERN APPLICATION
State Form 49856 (R / 10-08)
THIS FORM MUST BE FILED BY APPLICANTS WHO DO NOT HAVE A BACHELOR’S DEGREE IN A BOARD-APPROVED LAND SURVEYING CURRICULUM.
INSTRUCTIONS:
1.
Hours means semester credit hours. Please highlight any credits based on quarters.
a.
Total Math hours must include three (3) hours of calculus or differential equations.
b.
Total Science hours must include five (5) hours of physics.
c.
See attached Land Surveyor Education Requirements (01/03/2003 through 01/02/2009) for further information.
2.
All courses listed below must have been successfully completed by applicant.
3.
If additional space is required, copies may be made of this form.
Name of applicant
NAME OF INSTITUTION
COLLEGE LEVEL MATH
COLLEGE LEVEL PHYSICAL SCIENCES
COLLEGE LEVEL SURVEYING
COURSE NAME AND NUMBER
HOURS
COURSE NAME AND NUMBER
HOURS
COURSE NAME AND NUMBER
HOURS
TOTAL MATH HOURS
TOTAL SURVEYING HOURS
0
TOTAL PHYSICAL SCIENCE HOURS
0
0
SUB TOTAL
SUB TOTAL - PHYSICS
TOTAL SURVEYING HOURS
CALCULUS / DIFFERENTIAL EQUATIONS
3
5
27
REQUIRED
(5 hours required)
(3 hours required)
TOTAL PHYSICAL SCIENCE HOURS
TOTAL MATH HOURS REQUIRED
12
11
REQUIRED
(Including physics)
(Including calculus / differential equations)
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