Transcription of Application for Professional Engineer, Professional ...
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Application for Professional Engineer, Professional ...
Bureau of Professional Licensing PO Box 30670 Lansing, MI 48909 Telephone: (517) 241-9288 Professional engineer , Professional SURVEYOR, ORARCHITECT RELICENSURE Application (This Form Should Not Be Used For License Renewal) Authority: 1980 PA 299, MCL Legal Name (First, Middle, Last)Date of Birth Social Security Number Address City State Zip Code Permanent Number Telephone Number E-Mail AddressI have the ability and will serve the public in a fair, honest and open manner. If I have had a judgment of guilt in a criminal proceeding or a civil action against me, I am rehabilitated or the substance of my former offense is not reasonably related to the occupation or profession for which I am seeking a license.
Title: Application for Professional Engineer, Professional Surveyor or Architect Reliensure or Reinstatement Author: jodi cornell Subject: design board relicensure form
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