* - to be filled if applicableNote: CPD Application is to be submitted at least 2 months prior to CPD Activity date. ONLY COMPLETED CPD Application Form will be processed. Usage of BEM Logo in any promotional materials is strictly PROHIBITED.

BEM PRE-APPROVED CPD ACTIVITY

Checklist For BEM Use only

1 Official Cover Letter(with Letterhead) APPROVED / DECLINED

2 BEM Pre-Approved CPD Activity Form CPD Hour Approved: CPD Hours

Complete Submission Date:

4 Activity Brochure (if any)

CPD ACTIVITY

Title:

Date (Start): Date (End):

Venue:

Fees charged: RM per pax Organiser Stamp (Name and Address):

Contact Person:

Contact No.: Email

Address:

CPD Hours

Applied: CPD Hours

*Please refer basis of CPD Hours Applied for (Itinerary)

PROFILE: SPEAKER

Topic of Presentation:

Speaker Name:

Academic Qualifications:

Registration No.:

(BEM/BAM/BQSM)

Membership of

Professional Societies:

Experience: years

Please use additional sheets of paper if required

Submitted By:

Signature:

Name:

Position:

Date:

* - to be filled if applicableNote: CPD Application is to be submitted at least 2 months prior to CPD Activity date. ONLY COMPLETED CPD Application Form will be processed. Usage of BEM Logo in any promotional materials is strictly PROHIBITED.

BEM PRE-APPROVED CPD ACTIVITY

BASIS OF CPD HOURS APPLIED FOR (Itinerary) :

Date

Time

Topic of Presentation Contact Hours CPD Hours

Applied for

Total Contact Hours

Total CPD Hours Applied for

Please use additional sheets of paper if required

BEM CPD Hour Calculation Methodology

No. CPD Activity Eligible CPD Hours

Workshop/ Seminar/ Course/ Conference/ Talk/ Training

1 Engineering -Technical, Project Management, Construction Management

Speaker: Professional - Registered PE/PEPC/IOW/AC; or - Registered Architect or Quantity Surveyor

1 Contact Hour = 1 CPD Hour

Speaker: Subject Matter Expert < 10 years of experience 2 Contact Hours = 1 CPD Hour

≥ 10 years of experience 1 Contact Hour = 1 CPD Hour

2 Non-Engineering - General Management, Law, Contract, Insurance - Annual General Meeting (Engineering Societies)

2 Contact Hours = 1 CPD Hour

Project Site Visit/Study Visit/Technical Visit

3 ≤ 2 Hours (at Site) 1 CPD Hour

> 2 Hours (at Site) 2 CPD Hours

* - to be filled if applicableNote: CPD Application is to be submitted at least 2 months prior to CPD Activity date. ONLY COMPLETED CPD Application Form will be processed. Usage of BEM Logo in any promotional materials is strictly PROHIBITED.

BEM PRE-APPROVED CPD ACTIVITY

PROFILE: SPEAKER

Topic of Presentation:

Speaker Name:

Academic Qualifications:

Registration No.:

(BEM/BAM/BQSM)

Membership of

Professional Societies:

Experience: years

PROFILE: SPEAKER

Topic of Presentation:

Speaker Name:

Academic Qualifications:

Registration No.:

(BEM/BAM/BQSM)

Membership of

Professional Societies:

Experience: years

PROFILE: SPEAKER

Topic of Presentation:

Speaker Name:

Academic Qualifications:

Registration No.:

(BEM/BAM/BQSM)

Membership of

Professional Societies:

Experience: years

PROFILE: SPEAKER

Topic of Presentation:

Speaker Name:

Academic Qualifications:

Registration No.:

(BEM/BAM/BQSM)

Membership of

Professional Societies:

Experience: years

* - to be filled if applicableNote: CPD Application is to be submitted at least 2 months prior to CPD Activity date. ONLY COMPLETED CPD Application Form will be processed. Usage of BEM Logo in any promotional materials is strictly PROHIBITED.

BEM PRE-APPROVED CPD ACTIVITY

BASIS OF CPD HOURS APPLIED FOR (Itinerary) :

Date

Time

Topic of Presentation Contact Hours CPD Hours

Applied for

Total Contact Hours

Total CPD Hours Applied for

* - to be filled if applicableNote: CPD Application is to be submitted at least 2 months prior to CPD Activity date. ONLY COMPLETED CPD Application Form will be processed. Usage of BEM Logo in any promotional materials is strictly PROHIBITED.

BEM PRE-APPROVED CPD ACTIVITY

Checklist For BEM Use only

1 Official Cover Letter(with Letterhead) ⁄ APPROVED / DECLINED

2 BEM Pre-Approved CPD Activity Form ⁄ CPD Hour Approved: CPD Hours

Complete Submission Date:

4 Activity Brochure (if any) ⁄

CPD ACTIVITY

Title: BEM Roadshow 2020

Date (Start): 1) 31/07/2020

2) 02/08/2020

3) 15/10/2020

Date (End): -

Venue: THE ROYALE HOTEL

Fees charged: RM 150 per pax Organiser (Name and Address): BOARD OF ENGINEERS MALAYSIA

Tingkat 17, Blok F, Ibu Pejabat JKR,

Jalan Sultan Salahuddin,

50480 W.P Kuala Lumpur

Contact Person: CIK SITI

Contact No.: 03-226912090 Email

Address:

event@bem.org.my

CPD Hours

Applied: 7 CPD Hours

*Please refer basis of CPD Hours Applied for (Itinerary)

SPEAKER’S PROFILE

Topic of Presentation: Paper 1 : Safety in Supervision Works at Construction Site

Speaker Name: Ir. K. Sundraraj

Academic Qualifications: Degree : B. Sc. (Hons) Civil Engineering

- University of London, United Kingdom

Registration No.:

(e.g: BEM/BEM/BQSM)

C123456 (BEM)

Membership of

Professional Societies:

IEM, ACEM, ACPE Experience: 30 years

Please use additional sheets of paper if required

Submitted By:

Signature: siti

Name: CIK SITI

Position: Officer, BEM

Date: 01-01-2020

1) Fill in ALL the details

in CPD Activity

Use company’s

stamp

CPD Hours Applied will reflect

the Total CPD Hours applied

in the Itinerary

2) Fill in ALL the details

in Speaker’s Profile

3) Sign HERE

MANUAL

* - to be filled if applicableNote: CPD Application is to be submitted at least 2 months prior to CPD Activity date. ONLY COMPLETED CPD Application Form will be processed. Usage of BEM Logo in any promotional materials is strictly PROHIBITED.

BEM PRE-APPROVED CPD ACTIVITY

BASIS OF CPD HOURS APPLIED FOR (Itinerary) :

Date

Time

Topic of Presentation Contact Hours CPD Hours

Applied for

31/7/2020, 02/08/2020 & 15/10/2020

8.30 –

9.30AM

Paper 1: Safety in Supervision Works at Construction

Site

1 1

9.30 -

10.30AM

Paper 2: N/A 1 1

10.30 -

11.00AM

Coffee Break

11.00 -

12.00AM

Paper 3: N/A 1 1

12.00 -

1.00PM

Paper 4: N/A 1 1

1.00 -

2.00PM

Lunch Break

2.00 –

3.00PM

Paper 5: N/A 1 1

3.00 –

4.00PM

Paper 6: N/A 1 1

4.00 –

4.30PM

Coffee Break

4.30 –

5.30PM

Paper 7: N/A 1 1

Total Contact Hours 7

Total CPD Hours Applied for 7

Please use additional sheets of paper if required

BEM CPD Hour Calculation Methodology

No. CPD Activity Eligible CPD Hours

Workshop/ Seminar/ Course/ Conference/ Talk/ Training

1 Engineering -Technical, Project Management, Construction Management

Speaker: Professional - Registered PE/PEPC/IOW/AC; or - Registered Architect or Quantity Surveyor

1 Contact Hour = 1 CPD Hour

Speaker: Subject Matter Expert < 10 years of experience 2 Contact Hours = 1 CPD Hour

≥ 10 years of experience 1 Contact Hour = 1 CPD Hour

2 Non-Engineering - General Management, Law, Contract, Insurance - Annual General Meeting (Engineering Societies)

2 Contact Hours = 1 CPD Hour

Project Site Visit/Study Visit/Technical Visit

3 ≤ 2 Hours (at Site) 1 CPD Hour

> 2 Hours (at Site) 2 CPD Hours

4) Fill in the itinerary on hourly basis.

Series (same title, itinerary and speaker BUT different dates)

- 1 application form & 1 itinerary

1 organiser, different course (title, itinerary, speaker and dates)

- different application form

How to calculate

CPD Hours?

- Refer HERE

* - to be filled if applicableNote: CPD Application is to be submitted at least 2 months prior to CPD Activity date. ONLY COMPLETED CPD Application Form will be processed. Usage of BEM Logo in any promotional materials is strictly PROHIBITED.

BEM PRE-APPROVED CPD ACTIVITY

PROFILE: SPEAKER

Topic of Presentation:

Speaker Name:

Academic Qualifications:

Registration No.:

(BEM/BEM/BQSM)

Membership of

Professional Societies:

Experience: years

PROFILE: SPEAKER

Topic of Presentation:

Speaker Name:

Academic Qualifications:

Registration No.:

(BEM/BEM/BQSM)

Membership of

Professional Societies:

Experience: years

PROFILE: SPEAKER

Topic of Presentation:

Speaker Name:

Academic Qualifications:

Registration No.:

(BEM/BEM/BQSM)

Membership of

Professional Societies:

Experience: years

PROFILE: SPEAKER

Topic of Presentation:

Speaker Name:

Academic Qualifications:

Registration No.:

(BEM/BEM/BQSM)

Membership of

Professional Societies:

Experience: years

Extra Speaker?

- Use THIS template

* - to be filled if applicableNote: CPD Application is to be submitted at least 2 months prior to CPD Activity date. ONLY COMPLETED CPD Application Form will be processed. Usage of BEM Logo in any promotional materials is strictly PROHIBITED.

BEM PRE-APPROVED CPD ACTIVITY

BASIS OF CPD HOURS APPLIED FOR (Itinerary) :

Date

Time

Topic of Presentation Contact Hours CPD Hours

Applied for

Total Contact Hours

Total CPD Hours Applied for

Extra Sheet?

- Use THIS template