FUNDAMENTALS OF ENGINEERING AND LAND SURVEYING APPLICATION.pdf

Please mail all correspondence to: Residential Business FALL EXAM SPRING EXAM Exam: Please check the appropriate box for exam type. Please indicate how you are applying for the FE/FLS exam: $35 Fundamentals of Engineering Examination $35 Fundamentals of Land Surveying Examination Payment Type: NOTE: The applicant is responsible for reviewing the requirements for admittance to an exam. Please carefully read the Oregon laws and rules as application fees are non-refundable (OAR 820-010-0300). NOTE: ALL fees must be paid in full prior to the review process. You will not be scheduled for any exam until your application is complete (all verifications, transcripts, etc.) and approved by the Board office. Application fees are non-refundable (OAR 820-010- 0300). GENERAL INFORMATION If you are a foreign citizen unable to obtain a United States Social Security Number, please read the last page of the application or contact the Board office for further information. Exam Date: Please indicate exam date. ORIGINAL AND COMPLETED APPLICATION MUST BE POSTMARKED BY THE POSTMARK DEADLINE. THERE ARE NO EXCEPTIONS. 1. Full Legal Name Last Name (Jr., II, etc.) First Name Middle Name or Initial, as it should appear on your certificate. 2. Birth Date 3. Social Security Number ______ - _______ - ______ 4. Residential Mailing Address Home Phone City State Apartment No. Zip Code 5. Business Name/Mailing Address Business Phone Suite No. City State Zip Code CREDIT CARD NO. EXP. DATE ___________________________ _______ Accepted Cards: Visa, Mastercard, Discover, American Express CHECK / MONEY ORDER (Make checks money orders payable to OSBEELS) CASH FUNDAMENTALS OF ENGINEERING AND LAND SURVEYING APPLICATION EDUCATION EXPERI