THE CERTIFICATION OF ENGINEERING FORM MUST BE SENT TO ONE OT THE FOLLOWING EMAIL ADDRESSES: For Junior Engineers: accesprofession@oiq.qc.ca

For Exam Candidate examens_admission@oiq.qc.ca For Applicants : accesprofession@oiq.qc.ca

Update : 2017/05/29

CERTIFICATION OF ENGINEERING

EXPERIENCE ACQUIRED IN CANADA

INSTRUCTIONS - JUNOR ENGINEER You must complete a form per referee for each engineering job you have held. Forms sent to the Order will be added to your file and the

experience will be evaluated when you have acquired a total of 36 months of engineering experience. At least 12 months of experience must be in Canada. A minimum of two referees per job is required.

Certifications added to your file must include the signatures required. Original and electronic signatures will be accepted.

Incomplete engineering experience certification forms cannot be processed.

Please note that the term "junior engineer" used in this form also refers to individuals holding a temporary restrictive permit obtained under the Mutual Recognition Agreement on Professional Qualifications (MRA).

NUMBER OF FORMS TO BE COMPLETED PER JOB (JUNIOR ENGINEER ONLY) If your immediate supervisor (technical supervisor)

is an engineer If your immediate supervisor (technical supervisor)

is not an engineer 2 certifications 3 certifications

* Engineer personally familiar with your work. One of the referee engineers must have had direct control and supervision (DCS) over your work.

INSTRUCTIONS - CANDIDATE You must complete a form for each engineering job you have held.

Certifications added to your file must include the signatures required. Original and electronic signatures will be accepted.

Incomplete engineering experience certification forms cannot be processed.

Please note that the term "junior engineer" used in this form also refers to individuals holding a temporary restrictive permit obtained under

the Mutual Recognition Agreement on Professional Qualifications (MRA).

1st referee Immediate supervisor (technical

supervisor) Engineer*

2nd referee Engineer*

2nd referee Engineer*

3rd referee Engineer*

1st referee Immediate supervisor (technical

supervisor) Non-engineer

Update : 2017/05/29

INFORMATION ON JUNOR ENGINEER/CANDIDATE

File/member number Last name First name

Employer Job title or position

Employer's complete address including the country Email

Period of employment from: to : Full-time Part-time (yyyy/mm/dd) If applicable (yyyy/mm/dd)

If the job was part-time, specify: Period from : to : (yyyy/mm/dd) (yyyy/mm/dd)

Nbr hours/week

If there was a break in the work, specify: Period from : to : (yyyy/mm/dd) (yyyy/mm/dd)

INFORMATION ON REFEREE

Member number (if applicable) Last name First name

Employer Job title or position

Telephone Extension Email

Same address as the junior engineer's workplace. If the address is different, please complete the following section:

Employer's complete address

Relationship to junior engineer/candidate: Engineer Immediate supervisor (technical supervisor)

Non-engineer Immediate supervisor (technical supervisor)

Engineer (other), specify :

Initials junior engineer/candidate : _________ Initials referee : ________

Update : 2017/05/29

DESCRIPTION OF WORK EXPERIENCE

You must use your relevant work experience and accomplishments to demonstrate that you have acquired the core competencies of engineering and thus enable the OIQ to confirm that you have attained the level of professional autonomy required to practise the profession of engineer. You must include a brief description of the company as well as an explanation of your job, tasks and responsibilities. Also, you must indicate, for each engineering activity which core competencies you developed. You will find some examples of work description on the web site.

CONTEXT AND WORK SITUATION, RESPONSIBILITIES WITHIN THE COMPANY

TIME (%) ENGINEERING ACTIVITIES ACCOMPLISHMENTS CORE COMPETENCIES

Assume your status as a professional

Solve problems using applied sciences and trade practices

Communicate effectively

Ensure the quality of your work and activities

Manage technical risks

Manage activities, technical teams and projects

Assume your status as a professional

Solve problems using applied sciences and trade practices

Communicate effectively

Ensure the quality of your work and activities

Manage technical risks

Manage activities, technical teams and projects

NOTE: You may continue onto the next line if necessary or use next page for the same Engineering activity. You can add an appendix if the space is insufficient.

Initials junior engineer/candidate : _________ Initials referee : ________

Update : 2017/05/29

TIME (%) ENGINEERING ACTIVITIES ACCOMPLISHMENTS CORE COMPETENCIES

Assume your status as a professional

Solve problems using applied sciences and trade practices

Communicate effectively

Ensure the quality of your work and activities

Manage technical risks

Manage activities, technical teams and projects

Assume your status as a professional

Solve problems using applied sciences and trade practices

Communicate effectively

Ensure the quality of your work and activities

Manage technical risks

Manage activities, technical teams and projects

Assume your status as a professional

Solve problems using applied sciences and trade practices

Communicate effectively

Ensure the quality of your work and activities

Manage technical risks

Manage activities, technical teams and projects

100% TOTAL NOTE: You may continue onto the next line if necessary or use next page for the same Engineering activity. You can add an appendix if the space is insufficient.

Initials junior engineer/candidate : _________ Initials referee : ________

Update : 2017/05/29

CONSENT OF GRADUATES FROM OUTSIDE CANADA (CANDIDATE ONLY)

I acknowledge that my engineering experience is being evaluated in order to determine whether, under the Regulation respecting the standards for equivalence of diplomas and training for the issue of a permit by the Ordre des ingénieurs du Québec, I qualify for an equivalence of diplomas and training. I also acknowledge that under the Regulation respecting other terms and conditions for permits to be issued by the Ordre des ingénieurs du Québec, this experience will not necessarily be recognized when evaluating my engineering experience as a junior engineer.

Signature of candidate Date (yyyy/mm/dd)

DECLARATION AND SIGNATURE OF CANDIDATE/JUNIOR ENGINEER I certify and solemnly affirm that the information given on this form and any attached documents is true, accurate and unaltered.

I hereby give the Ordre des ingénieurs du Québec permission, if needed, to contact the individuals and organizations that have drawn up, signed, produced or certified the documents comprising my file for the purpose of verifying their truth and accuracy. I understand that a false declaration, failure to report a fact or the transmission of false, altered or fraudulently obtained documents may lead to sanctions, such as the suspension of my file, the refusal of my permit application or the revocation of my permit.

Signature of candidate/junior engineer Date (yyyy/mm/dd)

REFEREE’S EVALUATION OF WORK EXPERIENCE

Period for which you are evaluating the junior engineer's/candidate’s work experience and during which you were personally familiar with the work performed.

from : to :

(yyyy/mm/dd) If applicable (yyyy/mm/dd) Please check the statement that applies :

I exercised direct control and supervision (DCS) over the junior engineer's/candidate’s work during the period of time indicated above while I held an engineer's permit issued by the OIQ; I acknowledge that I have the necessary knowledge, skill and experience in the field in which the junior engineer/candidate worked to have exercised DCS.

I did not exercise direct control and supervision (DCS) over the junior engineer's/candidate’s work.

REMARKS

A. Please assess the level of professional autonomy attained by the junior engineer/candidate by selecting one of the ratings provided to describe each core competencies of engineering : Rating

Assume your status as a professional

Solve problems using applied sciences and trade practices

Communicate effectively

Ensure the quality of your work and activities

Manage technical risks

Manage activities, technical teams and projects

B. Percentage of experience acquired in engineering: %

Other: % Specify:

DECLARATION AND SIGNATURE OF REFEREE

I certify and solemnly affirm that the information given on this form and any attached documents is true, accurate and unaltered.

Signature of referee Date (yyyy/mm/dd)