Part 2 Testing

Personal details

Consent for storing submitted data *

Yes, I give permission to store and process my data

First name *

Surname *

Date of birth *

Gender *

Male

Female

IPEM membership number

Home address (including post code) *

Home telephone number

Home email

Work details

Work address (including department and post code) *

Work telephone number *

Work email *

Employer *

Job title *

Date appointed *

Specialist area *

Do you intend to apply for CEng in the future? *

Yes

Preferred correspondence address *

Home

Work

Education

First degree university *

First degree *

First degree subject *

First degree award level *

First degree award date *

Higher degree university *

Higher degree *

Higher degree subject *

Higher degree award level *

Higher degree award date *

Doctorate university

Doctorate

Doctorate subject

Doctorate award level

Doctorate date awarded

Additional information

(Thesis titles, project reports, publications & relevant previous training)

Supervisor details

Head of department name (including title) *

Head of department work address (including department and postcode) *

Head of department email *

Part II Supervisor name (including title) if different to Head of department

Part II Supervisor work address (including department) if different to Head of department

Part II Supervisor email (if different to Head of department)

Declaration

I wish to apply for enrolment with IPEM onto Part II Training and confirm that the information within this application is accurate and true. *

I have discussed this application with my Head of Department and they give their support. Confirmation has been received that appropriate facilities will be made available by the department to offer advanced training in the applicant's specialist subject area and other relevant topics and to participate in the IPEM Scheme for Continuing Professional Development. *

Document upload

Applications cannot be processed without a copy of your training plan, an up to date CV and your current job description. Accepted file formats are PDF, DOCX, PNG, JPG and GIF. When uploading multiple documents, click 'Choose Files', then select all required documents and upload together.

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