Individual Applicants

Individuals

Engineer Intern Certificate Application

General Information

Please complete all sections of the application.

Application Procedure

Only applicants with a Bachelor of Science in Engineering Technology (ABET) or a Bachelor of Science in Engineering (non-ABET) or science related degree (non-ABET) are required to upload the Evidence of Experience Form that details four years of progressive engineering experience from the date of graduation. The experience cannot have any gaps and must also include non-engineering experience.

Applicant Details

Passport Sized Recent Head and Shoulder Photo 2 x 2 inches (51 x 51 mm)
Upload as JPEG

Last Name

First

Middle Name

Suffix

Board records, wall certificate and your seal will reflect first name, middle initial and last name unless another preference is indicated below.

Name Preference

SSN Last 4

Birth Date

NCEES ID

Physical Residence Address

Address 1

Address 2

City

State

Zip

Phone

Mobile

Email

The Board communicates with its licensees by e-mail to include renewal notices.
It is recommended that you provide the Board with two different e-mail addresses, particularly if you use an e-mail address with a .gov, .mil or .edu extension as those will often block e-mail from Constant Contact, which is the company the Board uses for mass e-mails.

Confirm Email

Second Email

Confirm second email

Physical Business Address

Business Name

Address 1

Address 2

City

State

Zip

Phone

Mailing Address

Same as

Residence

Business

Address 1

Address 2

Address 3

City

State

Zip

Experience

https://www.ncbels.org/wp-content/uploads/2019/03/EvidenceofExperience.pdf

Upload evidence of experience in PDF format below.

Education Information

University/College Name:

BS-ABET Accredited

PhD

BS - ABET Accredited Engineering Technology

BS - Non-ABET Accredited Science Related

Date of Graduation:

Degree Conferred - (Civil, Mechanical, Electrical, etc.)

References

References: Three individuals who are familiar with the applicant's work, character and reputation, one of which must be a Professional Engineer.
Reference forms must be mailed directly to the NC Board office in sealed envelopes with the reference's signature across the back flap.

Name	PE/PLS	Licensed State

Background

Have you previously applied for certification as an EI in North Carolina?

Yes

No
Have you previously applied for certification as an EI or licensure in any other state and been denied?

Yes

No

You must upload details in PDF format below.
Have you ever been disciplined on any professional license?

Yes

No

You must upload details in PDF format below.
Have you ever been convicted of a felony?

Yes

No

You must upload proof of restoration of civil rights in PDF format below.
Have you ever been convicted of a misdemeanor? (Do not include traffic violations.)

Yes

No

You must upload details in PDF format below.
Are you a U.S. citizen?

Yes

No

Provide detailed explanation of legal status in PDF format below.
Are you active duty military or a military veteran?

Yes

No
Are you an active duty military spouse?

Yes

No
Did you take the computer-based Fundamentals of Engineering examination?

Yes

No

Written exam state

Written exam date

If the applicant took a written exam, the applicant must have the examination verification sent directly to the North Carolina board from NCEES or the verifying board.
Does NCEES have an official verified transcript from your educational institution?

Yes

No

The applicant must have the educational institution send an official transcript to the Board either by mail or e-mail (transcripts@ncbels.org).

All information provided is true from my personal knowledge and I understand that any untruthful information may be grounds for denial of certification as an Engineer Intern.

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