washington accord application form

Upload: jc83

Post on 12-Oct-2015

7 views

Category:

Documents


0 download

DESCRIPTION

form

TRANSCRIPT

  • The pathway applies to persons who hold an accredited professional engineering undergraduate qualification (equivalent to an Australian four year Bachelor of Engineering degree) from any of the Washington Accord signatory countries.It is recommended that the applicant check the accreditation status of the qualification (including engineering specialisation and date of award/entry) with the appropriate signatory body before applying.

    PAGE 1 of 2

    Please affixa passport size

    photograph here

    COMPULSORY DOCUMENTATION YOU MUST PROVIDE THE FOLLOWING DOCUMENTS:

    Certified copy of passport bio-data page, or National Identity card. Certified copy of Formal Degree/Diploma or Certificate for first and any subsequent qualification(s). Certified copy of academic transcript (ie list of subjects studied with results shown). Brief Resume/Curriculum Vitae.

    Notes: 1. Applicants MUST copy all submitted material - documents submitted will NOT be returned. 2. If additional services requested per section D of MSA Booklet, all specified evidence must

    also be included.

    Office use only CID

    Application for Migration Skills Assessment WASHINGTON ACCORD QUALIFICATIONS(Professional Engineer)

    PERSONAL DETAILS (PLEASE USE BLOCK LETTERS AND TICK THE APPROPRIATE BOXES BELOW)

    Title: Prof Dr Mr Mrs Ms Miss Other (please specify) ......................................

    Family Name: .................................................................................................................................................................................

    Given Names (in full): .................................................................................................................................................................

    Date of Birth: ........../........../.......... Country of Birth ............................................. Gender: Male Female

    Applicants Current Address: ....................................................................................................................................................

    City: .................................................................. Country: .................................................................. Postcode: .......................

    Phone: ......................................................................................... Mobile: ..................................................................................

    Email: ................................................................................................................................................................................................

    Country of undergraduate qualification: ........................................................ Date of Award: ........../.........../..........

    Applicants Signature: ................................................................................................. Date: ........./........../..........

    day month year

    day month year

    day month year

    METHOD OF PAYMENT (PLEASE TICK THE APPROPRIATE BOXES BELOW)

    Assessment Specification Applicants living Overseas Applicants living in Australia

    Fees (GST exc.) Tick(s) Fees (GST inc.) Tick(s)

    Standard Accord assessment AUD $310 AUD $341

    Relevant Skilled Employment AUD $250 AUD $275

    Overseas PhD AUD $200 AUD $220

    Total Payment AUD $ AUD $

    This must be paid at the time of lodgement of this form and completed documentation. The fee is NOT refundable.

    The Payee is ENGINEERS AUSTRALIA for payments made using cheque, money orders and bank drafts. Overseas applicants using this form of payment MUST ensure that the bank draft is drawn in Australian Dollars ONLY to a bank operating in Australia. All international use of credit cards MUST be cleared by your bank.

    Bank Draft/Money Order drawn to an Australian bank in Australian dollars

    Cheque Australian Money Order Credit Card (see below).

    Credit Card Details Please charge credit card (tick one) American Express Visa Mastercard

    Credit Card No:

    Cardholders Name: .................................................................................................................. Expiry Date: .........../...........

    Amount: AUD$ ........................ Cardholders Signature: ............................................... Date: .........../............/...........day month year

    month year

    WA

    SHIN

    GTO

    N A

    CC

    OR

    D(P

    rofe

    ssio

    nal E

    ngin

    eer)

    Mail to: Migration Skills Assessment, Education and Assessment, Engineers Australia, 11 National Circuit, BARTON ACT 2600 Australia

  • CERTIFICATION OF COPIES OF DOCUMENTS

    Properly-certified copies of ORIGINAL documents are required. Certified copies of previously certified copies will not be accepted.

    Proper certification should appear on each page to be certified, and show: The signature of the person certifying the document The name of the person certifying the document clearly printed or evident in the official stamp Contact details of the person certifying the document Where possible an official stamp indicating the status of the person certifying the document, ie:

    Justice of the Peace, Commissioner for Oaths, or Notary Public, etc, or name of law firm indicated.

    The following classes of persons are authorised to certify copies of documents: A current Financial Member of Engineer Australia (other than at the Student grade).

    The membership number must be shown A Staff Member of Engineers Australia A Notary Public authorised in the country of application A Commissioner for Oaths (Declarations) authorised in the country of application A Lawyer, Solicitor, Barrister or Judge authorised in the country of application A Justice of the Peace authorised in Australia or in the country of application

    If the services of a legal firm are employed, the name of the solicitor certifying the documents must be provided. It is not sufficient to simply provide the name of the law firm.

    Application for Migration Skills Assessment WASHINGTON ACCORD QUALIFICATIONS(Professional Engineer) (continued)

    PAGE 2 of 2

    WA

    SHIN

    GTO

    N A

    CC

    OR

    D(P

    rofe

    ssio

    nal E

    ngin

    eer)

    APPOINTMENT OF A PERSON TO ACT AS AGENT

    Agents Name: ................................................................................................................................................................................

    Agents Address: .............................................................................................................................................................................

    ..............................................................................................................................................................................................................

    Agents Registration Number (if applicable): ......................................................................................................................

    Agents Phone: ...............................................................................................................................................................................

    Agents Email: ................................................................................................................................................................................

    If you are using an Agent, then you must complete this part of the form. Otherwise, leave blank.Note: All correspondence will be sent to the Agents address entered below

    I, .................................................................................................................................................................... (applicants name)

    of (address): ....................................................................................................................................................................................

    City: ....................................................................................................................................................................................................

    Postcode: ........................................................................... State/Territory/District: ......................................................

    Country: .............................................................................................................................. born on: ........../........../..........

    agree to the following person acting on my behalf in relation to my application for assessment.

    Applicants Signature: ............................................................................................................ Date: ........./........../..........day month year

    day month year

    Visit us at www.engineersaustralia.org.au

    CM0813