Please Affix

-SAMPLE- Reg. No. _______________ Recent Photo

APPLICATION FORM
APEC Engineer
1. Personal Information (as shown on passport)
First Name _____ Mr. Anan _ __ Middle Name ___________________________ Last Name ___________ Rakthai ____________
Gender √ Male Female Nationality _______ Thai _______ Date of Birth (DD/MM/YYYY) _____ _1 January 1979 ___ _
Citizen ID __ __ 1-1111-11111-11-1 ____ Passport No. _____ AA 123456_ ____ Passport expiry date ______5 September 2018_______
Contact Address __ _____ 1 Soi Ramkhamheang 41 Ramkhamheang Road Wangthonglang __ __________________
Province ____ _____ Bangkok ___ _______ Postcode ________ __ 10310 ___________ Mobile No. _______ 081 010 1010_ _____
Tel: __ ____ 02 777 7777 __ __ __ Fax: __ _ 02 888 8888 ________ E-mail:____ [email protected]_______________________________
2. Professional Information
Associate Engineer License No. (Discipline) AE 12121 (Civil) _ Issued date _ 01/ 01/ 2003 Expiry date _ 01/ 01/ 2008___
Current PE License No. (Discipline) PE 12121 (Civil) Issued date 01/ 01/ 2013 _ Expiry date _ _ 01/ 01/ 2018 __ _
Present Company Name ______________ ABC Engineering Co., Ltd. ________________________________________ ________
Company Address ____ _ 487 Soi Ramkhamheang 39 Ramkhamheang Road Wangthonglang ________ __________
Province ______ _____ Bangkok ____ ______ Postcode _______ ___ 10310 ___________ Tel: ________ 02 935 6868 ___ _______
Fax: __ ___ __ 02 935 6697_ __ ___ E-mail: _______________ [email protected] _____ _______________________
3. Engineering Education
Undergraduate Degree ____ _______ Bachelor of Engineering ___ __________ University/Institute __ __Chulalongkorn university______
Year of graduation ______________ 2001 ___________ Discipline of Engineering ___________ Civil Engineering ___ _____ _______
Post Graduate Degree _ ___ _____ Master of Engineering _________ _ University/Institute __ __Chulalongkorn university______
Year of graduation _______________ 2008 _____________ Discipline of Engineering __ Civil Engineering ________ _________
4. Discipline for APEC Engineer Regulation 5. Responsible Charge/ Expertise
(Please mark only one discipline which you desire to register as an APEC Engineer) (Can be more than one if applicable)

Civil Mining Consultancy Analysis and Design

Mechanical Electrical Project Planning Engineering Supervision
Industrial Chemical Investigation
Environmental Other ________________ Operation and Maintenance

I, the undersigned, apply for the registration as APEC Engineer through the Thailand Monitoring Committee and declare as follows;
(a) I confirm that all the information I have given in APEC Engineer application form and the enclosed certificates are true.
(b) I shall be bound by the Professional Engineer Act and the Professional Engineer (Code of Professional Conduct and Ethics) Rules
established and enforced by the Council of Engineers, Thailand.
(c) I shall be bound by the APEC Engineer Agreement and other relevant commitments in the future.
July 1st, 2014 Anan Rakthai
____________________ ____________________________
Date Signature of Applicant
 Reg. No. _________________
-SAMPLE-
Professional Experience

Detailed Description of Engineering Work

(Please describe the contents and significance of the work, the applicant’s role, and the degree of the applicant's
responsibilities about 50 words.)
Work Starting Date- Position and Project Details of Engineering Work
No. Ending Date Name of Owners/
(months) Organizations Clients
1. November Lead Engineer Northern - Preparation of and environmental improvement plan (6 months)
2012 – Present - ABC Co., Ltd. Improvement (Mr. Anan worked out a plan to improve highways of olden times form a new viewpoint by
Company taking into consideration natural, historical and cultural resources in a regional area.)
- Preparation of an integrated “Historical Road” improvement and utilization
plan

2. May 2010 – Project Engineer Ministry of Urban - Ensuring with the assistant engineer that all utilities are co-ordinate to meet
August 2012 - Ministry of Urban programmed deadlines, including diversion / upgrading / disconnection
works.
- Identify options and recommend solutions to resolve technical issues.
- Designing tunnels and underground structures.
- Negotiating with Statutory Authorities for the provision of main services.
- Mentoring and supervising junior staff.

3. October 2009 – Engineer Chino – Mr.Metro - Preparation of guideline for streetscape development (draft) (3 months)
March 2010 Asia Co,. Ltd. Antonio - Study of policy for Environmental improvement in Urban and regional Areas (2
months)

4. February 2008 Engineer – ABC International - Establishment of urban landscape improvement plan (6 months)
– July 2009 H. Engineer Co,. Ltd. landscape - Establishment of integrated basic plan for built-up urban area redevelopment (11 months)
architecture,
(Serving as the coordinator between the municipalities and localities, Mr. Anan work out
planning and urban
design an integrated basic plan for built-up urban area redevelopment)

5. January 2005 – Assistant Engineer Mori Real - Study of methods for planning and adjusting buildings and road facilities
November – ACE A Co,. Ltd. Property - Study of relationship between street image and landscape elements
2007
6. August 2003 – Assistant Engineer Mekong Road - Arterial road network improvement planning
September – Engineering Co,. and Bridge
2004 Ltd. Construction
Sum of Experience 9 Years 5 Months

Note: The professional experience should be referred to professional practices record

 Reg. No. _________________

Professional Practices Record

Engineering Work Experience
(Please describe in retrospective order, beginning with the most recent one.) Attesting Witnesses’ Column
Work Name of Project Starting Date - Professional Practices Duty/ Scope of Outcome/ Signature Remark
No. Organizations Owners/ Ending Date Work Performance
(Position/Title) Clients (months)
1 ABC Co., Ltd./ Mr. Guy Bee November 2012 - Preparation of and environmental improvement plan (6 Project Reviewing and
Lead Engineer – Present months) Consultancy and approving
- Preparation of an integrated “Historical Road” improvement Planning project (Mr. Guy Bee)
and utilization plan Engineering
- communicating and liaising effectively with colleagues and
architects, subcontractors, contracting civil engineers,
consultants, co-workers and clients;

2 Ministry of Urban / Mr. Isaraphap May 2010 – - Ensuring with the assistant engineer that all utilities are co- Project The project is
Project Engineer Jaiyai August 2012 ordinate to meet programmed deadlines, including diversion / Consultancy finished on time
upgrading / disconnection works. and within (Mr. Isaraphap Jaiyai)
- Identify options and recommend solutions to resolve technical budget.
issues.
- Designing tunnels and underground structures.
- Mentoring and supervising junior staff.

Sum of Experience in Responsible Charge of Professional Practices 3 Years 10 Months

Note: 1. The applicant has spent 2 years in responsible charge of professional practices
2. The signor(s) above shall be, in principle, the applicant’s direct supervisor(s) or any professional engineer/senior engineer under the applicant has executed his engineering works.
 Reg. No. _________________
-SAMPLE-
Monitoring Committee Summary
APEC Engineer

Name of Applicant _____________________________________________________________________________

PE License/Certificate No. __________________________________________ Issued by Council of Engineers

Issued date (DD/MM/YYYY) _______________________ Expiry date (DD/MM/YYYY) _____________________

Thailand Registered Engineer Registration No. ______________________ Issued date ___________________

Thailand Registered Engineer’s Discipline _________________________________________________________

APEC Engineer Discipline _______________________________________________________________________

Certified Compliance with APEC Engineer Criteria

Completed an accredited or recognised engineering program, or assessed recognized equivalent

Been assessed within their own country as eligible for independent practice

Gained a minimum of seven years practical experience since graduation

Spent at least two years in responsible charge of significant engineering work

Confirmed signature on statement of compliance with codes of ethics

Signed

(__________________________) (__________________________)
Delegated Chairman
Monitoring Committee (Thailand) Monitoring Committee (Thailand)
Date ________________________ Date ________________________