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Professional Engineering Form 2

The University of the State of New York THE STATE EDUCATION DEPARTMENT Office of the Professions Division of Professional Licensing Services 89 Washington Avenue Albany, NY 12234-1000 CERTIFICATION OF Professional EDUCATION Social Security Number Birth Date If different from above, print the name under which your degree was awarded: _____ 5 Month Day Year SECTION I: APPLICANT INFORMATION 1.

Complete if your program is accredited by the Accreditation Board for Engineering and Technology (ABET) (Check only one box) The applicant: has completed 3 years and is within twenty (20) credits of graduation in a baccalaureate program in ENGINEERING, which is

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