APP-REG-FORM-D1 Registration As A Professional Certificated Engineer

Form No.
:
Effective Date: Office Use
APP-REG-FORM- Revision No.: 2
14/02/2022
D1
Subject: Registration as a Professional Certificated Engineer
Compiler: Approving Officer: Next Review Date:

Page 1 of 20
MB Mtshali EL Nxumalo 14/02/2026
Form D1.1
Ref.:
NB: Please consult the Information Sheets (Sheets D1.1 & D1.2) before completing this Application.
1. General Information:
Surname: Title and First Names:
PHOTOGRAPH
(Passport-type.
Please paste -
Date of Birth: Identity No: do not staple)
Or Passport No.
Country Passport: Alternatively,
insert
*Race Group Asian: Black: Gender Male: Country of normal electronically in
Please tick the Please tick residence: JPEG or similar
the format
applicable block Coloured: White: Female:
applicable
Indian: block) Other:
Residential Address: Postal Address: Employer Name & Address:

Street Number: Postal Box Employer:
Street Name City/District: Street Number:
City/District: Province: Street Name:
Province: Country: City/District:
Country: Zip Code/ Postal Code: Province:
Zip Code/ Postal Code: Country:
Zip Code/ Postal Code:
Tel. No. (Home): Title of Position held: Tel. No. (Employer):
Tel. No. (Work): (include area codes) Fax No.: (include area codes)
Cell No.: E-mail:
E-mail:
*Completion of this section is necessary to accurately reflect equity statistics in terms of Employment Equity Act, No 55 of 1998. Please cross
applicable blocks.
2. (All qualifications at tertiary level other than Government Certificates of

Qualifications:
Competency.)
Copies Office
Educational Institution Qualification Year obtained attached use
NB: Kindly initial this page in the presence of a Commissioner of Oaths / Justice of Peace.
Commissioner Of Oaths/
Applicant: …………………………. Justice Of Peace: ………………………………………
CONTROLLED DISCLOSURE
It is the responsibility of the user to ensure that the latest version is used. The latest version will be published on ECSA Document Management system.
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Form D1.2
3. Government Certificates of Competency: (Complete for each certificate held)
Type of Certificate Date Certificate Office Type of Certificate Date Certificate Office
Issued Number Use Issued Number Use
MH&S Act – Electrical MH&S Act – Manager (Metal)

MH&S Act – Mechanical MH&S Act – Managers (Coal)
OH& S Act – Electrical MS Act – Ch Eng Off : Forgn
Going
OH&S Act – Mechanical xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxx xxxxxxx
x
4.Legal Appointments: (Spanning a minimum of 1 Year NON-ACTING)
Act/Regulation under which Appointed Date from Date to Employer Copy attached
5.Previous / Current Registration or Application Details: (eg. Candidate Engineering Technologist,

Professional Engineering Technician, etc.)
Type Category Number Date
Previous Registration:
Current Registration:
Previous Application:
6. Membership of Voluntary Associations recognised in terms of Act No 46 of 2000 (or other):
(If more space is needed, please supply information separately.)
Name of Association / Institute / Society Membership grade and date of admission
7. Application Fee: (Fees are available on ECSA website under the tab Annual Fees)
Please note: Only electronic payment will be accepted, please attach proof of payment
My Application fee of R ___________________ is transferred electronically.

8. Referees:
(1) (2)
E-mail: E-mail:
Tel No: Tel No:
NB: Kindly initial this page in the presence of a Commissioner of Oaths / Justice of Peace.
Commissioner of Oaths/
Applicant: …………………………. Justice Of Peace:……………………..
Office Use Only
Application fee: R _________
Received by: _________________________ Date: ____________________

(Council’s stamp)
Note: Voluntary Associations List is available on the ECSA website or http://www.ecsa.co.za

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9. Declaration:
I____________________________________________________________ (full names)
ID No. __________________________________, hereby in application to ECSA
 I lawfully declare to abide by all the provisions of the Engineering Profession Act, 2000 (Act
No. 46 of 2000) and any Rules published thereunder, including the Code of Professional
Conduct.
Now therefore I further declare explicitly to the following:
Item Description Yes No

i. That I have never been removed from an office of trust on account of improper
conduct;
ii. I have never been convicted of an offence in the Republic, other than an offence
committed prior to 27 April 1994 associated with political objectives, and was
sentenced to imprisonment without an option of a fine, or, in the case of fraud, to a
fine or imprisonment or both;
iii. I have never been convicted of an offence in a foreign country and sentenced to
imprisonment without an option of a fine, or, in the case of fraud, to a fine or
imprisonment or both
iv I have never been declared by the High Court to be of unsound mind or mentally
disordered, or is detained under the Mental Health Act, 1973;
v That I have never been disqualified from registration as a result of any punishment
imposed on me under this Act
vi I have never been declared rehabilitated insolvent whose insolvency was caused by
my negligence or incompetence in performing work falling within the scope of my
registration(s).
I am cognisant of the fact that should the provisions referred to above as depicted under Section
19(3)(a) of the ACT be contrary, Council may refuse my application.
I solemnly declare that, to the best of my knowledge, all the information contained in my application is
true and correct.
Signature: ______________________________
I hereby certify that the Applicant has acknowledged that he/she knows and understands the
contents of this declaration which was sworn to and signed before me at
_____________________on this...........day of...........................20.., the regulations contained in
Government Notice No. R1258 dated 21 st July 1974, as amended, having been complied with.
Commissioner of Oaths/ Justice of Peace:
……………….……………………………
PRINT NAME
……………….…………………………
SIGNATURE (Commissioner’s stamp)
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Sheet D1.1
Information Sheet for Applicants applying for
Registration as a Professional Certificated Engineer
A. General:
(i) The Council will only consider your application for registration as a Professional Certificated
Engineer if the following documents are submitted:
 Complete the Application Form in full
 Completed Application Form (D1.1 & D1.2).
 Certified copies of qualifications.
 Certified copies of Certificate of Competency.
 Certified copies of applicable legal appointment documentation.
 Completed Training/Experience Report (Forms D2.1), one for each training/experience
period and a Summary of Training/Experience Reports (Form D2.2).
 Referee/Employer Report(s), duly completed on Form D4.1 & D4.2.
 Pre-Registration Professional Development Report (Form D5).
(ii) Please submit complete information.

(iii) All questions must be answered.
(iv) In completing all forms use type or print clearly in black ink to ensure clear copying.
(v) All supporting documents must be clearly marked for purposes of identification.
(vi) Application fee must accompany the completed application. NB. See item 7 below.
Please note the following:

 Your application for registration will only be considered when all referee reports have been received by
the Council. If the referee reports do not reach the Council within a reasonable time, you will be
notified accordingly. You will then be expected to contact the referees.
 Each applicant will be advised of the Council’s decision within 4 four months of receipt of the
application form, provided the applicant have submitted all required documents and no telephonic
information regarding the progress of any application will be given.
 Please note that it is your responsibility to ensure that all reports reach the Council’s offices
timeously.
Applicants who have a recognised qualification including a recognised certificate of competency, but who
do not have appropriate post-qualification experience may be registered as candidate certificated
engineers.
B. Application Form:
The following information is given to assist applicants to complete this form – the numbers refer to the
equally numbered sections of the Application Form.
1. General Information: Ensure that all personal details are correct. A recent passport-type photograph
of the applicant is required.
2. Qualifications: Original certified copies of your qualification certificate(s) leading up to attainment of

your certificate of competency must be submitted.
3. Certificates of Competency: The Certificates of Competency (which should not be of limited scope)
recognised in terms of the Engineering Profession Act, are given below:
¹ Electrical Engineer’s Certificate of Competency issued i.t.o. the Mines Health and Safety Act (MH&S Act)
¹ Mechanical Engineer’s Certificate of Competency issued i.t.o. the MH&S Act
² Electrical Engineer’s Certificate of Competency issued i.t.o. the Occupational Health and Safety Act (OH&S Act)
² Mechanical Engineer’s Certificate of Competency issued i.t.o. the OH&S Act
Manager’s Certificate of Competency (Metalliferous) issued i.t.o. the MH&S Act
Manager’s Certificate of Competency (Coal) issued i.t.o. the MH&S Act
³ Chief Engineer Officer – Foreign Going Certificate of Competency issued i.t.o. the Merchant Shipping Act (MS Act)
¹ Previously also known as the Mines and Works Certificate. ² Previously also known as the Factories Certificate.
³ Previously also known as the Chief Marine Engineer Officer Class 1 Certificate.
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Give the details required for each certificate held.
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Sheet D1.2
4. Legal Appointments: As a minimum, an applicant must have been appointed in terms of current (or
previous) safety Acts and regulations, and must furnish the Council with certified copies of the letters and
supporting documentation. (Subparagraph (a) of paragraph 3.2.2 of ECSA Policy Statement R1/1.) It is of
vital importance for an applicant to state the date on which he/she was appointed in terms of the relevant
Act as the legal responsible person and to attach a certified copy of the letter of appointment. The
appointment(s) shall be for at least 1 year in a capacity which requires the possession of a relevant
Government Certificate of Competence (NON-ACTING)
5. Previous/Current Registration or Application details: If you have previously applied for registration in any
category, or were previously registered but your registration was cancelled for any reason, please provide category
and registration number in relevant block. If you are currently registered in another category, also complete the
appropriate block.
6. Membership of recognised Voluntary Associations: A list of associations recognised by Council is available

on ECSA website. Proof of current membership of such associations will qualify you for a reduction in your annual fee
should your application be successful.
Persons who have applied for membership of any of the above-mentioned associations, but who have not yet been
accepted, must indicate this in the appropriate block. Membership of other institutes/societies (not recognised) may be
stated, but this does not qualify the applicant for a reduction in the annual fee.
7. Application and Annual Fees:
Application Fees
Proof of electronic payment must accompany the application form, as no other forms of payment will be
accepted. The applicant should make payment into ECSA’s Bank account: Standard Bank account Number
221285938, Current account, Branch code, 018505. When making the payment please ensure that the applicant’s
name and initials are entered in the field named “Depositor’s name and for reference number use Identity number
(this applies to new applicants who do not have ECSA profile numbers). For information on applicable fees, refer to
ECSA’s website at http://www.ecsa.co.za, click on “Annual Fees” or contact the Council’s offices at 0861225555 to
obtain the latest applicable fees.
Annual Fees
Proof of electronic payment must accompany the application form, as no other forms of payment will be
accepted. The applicant should make payment into ECSA’s Bank account: Standard Bank Number 221285938,
Current account, Branch code, 018505. When making the payment please ensure that the applicant’s name and
initials are entered in the field named “Depositor’s name and for reference number use your ECSA profile/account
number (i.e. the number that starts with ECSA). For information on applicable fees, refer to ECSA’s website at
http://www.ecsa.co.za, click on “Annual Fees” or contact the Council’s offices at 0861225555 to obtain the latest
applicable fees.
8. Referees:
Each applicant must, with the permission of the persons concerned, supply the Council with the names and
addresses of two referees. Referees must be senior to the applicant during the period of reference,
should have personal knowledge of the applicant's character as well as of his engineering
experience and legal appointment(s) and be registered with ECSA as either a Professional
Certificated Engineer or a Professional Engineer. At least one referee must be a Professional
Certificated Engineer and at least one referee must have personal knowledge of your current period
of employment and experience.
Use Form D3 for formal correspondence with each referee, and enclose copies of the referee report (Form
D4.1 & D4.2) and the guideline for referees (Sheets D4.1 & D4.2). It is suggested that you provide each
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referee with an addressed envelope with prepaid postage for the referee to forward the report direct to
Council.
9. Declaration: Section 19(3)(a) of the Engineering Profession Act, 2000 (Act No. 46 of 2000) reads:
“Despite subsection (2), the Council may refuse to register an applicant -
(i) if the applicant has been removed from an office of trust on account of improper conduct;
(ii) has been convicted of an offence in the Republic, other than an offence committed prior to 27 April 1994 associated with political
objectives, and was sentenced to imprisonment without an option of a fine, or, in the case of fraud, to a fine or imprisonment or
both;
(iii) if the applicant has, subject to paragraph (b), been convicted of an offence in a foreign country and was sentenced to imprisonment
without an option of a fine, or, in the case of fraud, to a fine or imprisonment or both;
(iv) if the applicant is declared by the High Court to be of unsound mind or mentally disordered, or is detained under the Mental Health
Act, 1973;
(v) for as long as the applicant is disqualified from registration as a result of any punishment imposed on him or her under this Act;
(vi) if the applicant is an unrehabilitated insolvent whose insolvency was caused by his or her negligence or incompetence in
performing work falling within the scope of the category in respect of which he or she is applying for registration.”
Note that your application must be sworn to or affirmed before a Commissioner of Oaths or a Justice of Peace.
Your attention is drawn to the initialling required at the bottom of the first page of the Application Form.
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Form D2.1
TRAINING/EXPERIENCE REPORT
PROFESSIONAL CERTIFICATED ENGINEERS
Surname and Initials: ________________________________________________________________________
Consult the enclosed Information Sheet (Sheets D2.1 & D2.2) before completing this
report.
Period No: Date from: to: Position No. of
held: Months:
Was this period covered by a legal appointment? Yes ____ No ____ If yes, state the Act and Regulation concerned.
Act: _____________________________________________________ Regulation: _______________________

Employer Name & Address: Supervisor’s Name and Address: Supervisor’s Signature:
Date:
ECSA Registration No:
Signature of Applicant: ______________________________ Date: ____________________

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Form D2.2
SUMMARY OF POST CERIFICATE TRAINING/EXPERIENCE REPORTS : PROFESSIONAL CERTIFICATED ENGINEERS
Surname and Initials of Applicant: __________________________________________________________________

First complete a Form D2.1 for each period.
Period Dates (inclusive) Period
No: in, months (post Employer Post held Legal Subject and type of work
From: To: obtaining GCC). Appointment –state act &
regulation
Total months:
Signature of Applicant: ___________________________________ Date: _______________________________
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Sheet D2.1
Information Sheet
for the completion of the
Training/Experience Report
1. To register as a Professional Certificated Engineer, a minimum period of three (3) years

appropriate post-Government Certificate of Competency experience, which shall include
a legal appointment as a Certificated Engineer for at least one (1) year, and updating of
competence throughout, is required. Only experience and legal appointments, which
meet the following requirements, shall be considered:
1.1 Legal appointment:
An appointment, which requires the possession of a Government Certificate of

Competency, as a Manager or as an Engineer in terms, of Regulation 2.6.1, or
Regulation 2.13.1, 2.13.3.1 and 2.13.3.2 respectively of the Mines Health and
Safety Act, 1996 (Act No. 29 of 1996), or if appointed in terms of Section 3.1(a),
4.1 or 2(a) where they are required in terms of their appointment to assume the
responsibilities of the Regulation 2.6.1 appointee requiring a GCC,_ or as an
Engineer in terms of Regulation GMR 2.1 or 2.7 of the Occupational Health and
Safety Act, 1993 (Act No. 85 of 1993) or as a Chief Engineer Officer – Foreign
Going on a vessel with a registered power of no less than 3 000 kW in terms of
the Merchant Shipping Act, 1951 (Act No. 57 of 1951), or in terms of any Act
which preceded or superseded any of the Acts mentioned above, and which
demonstrates the applicant’s competence to implement and manage the
provisions of these Acts, and ensure the safe operation and maintenance of plant
and equipment .
1.2 Experience:
Experience gained in engineering design, draughting, problem solving,

construction, training and management - project, construction, quality and
general, provided that at least two (2) of the required three (3) years of
experience are directly concerned with the installation, operation and/or
maintenance of machinery which requires sound engineering judgement, ability to
work in a team, sound communication skills and management and which
demonstrates the applicant’s competence at the required level of a certificated
engineer over the full three year period.
Experience as a mine captain / overseer / general engineering supervisor whether
with or without a legal appointment does not count as appropriate experience.
2. In the case of marine engineers, as an alternate to the specified experience above, the
following will be considered:
Experience gained as the appointed Chief Marine Engineer Officer for five (5) years, on a
variety of vessels with registered power of no less than 2 200 kW plus at least six (6)
months experience in an acting capacity as Supervising Marine Engineer, with proven
continuing updating of competence during this period, will be considered in lieu of the
experience specified above.
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Sheet D2.2
3. In completing the report you should note the following:
3.1 Your engineering experience must be completed in chronological order from the
date you obtained your certificate to the date of application. The report must be
completed without any gaps. Each Form D2.1 must be numbered chronologically.
3.2 Use no more than 200 words to describe each period of training/experience.
3.3 The information given on each Form D2.1 should be adequately detailed to permit
an assessment of the level of engineering work performed.
3.4 If you have been promoted during the above period, or you received a legal
appointment, or if the level of your responsibility or function has changed, or if you
have changed employers, describe your training/experience after the change-
over under a new period number. This is required in order to enable you to
indicate clearly the changes in your responsibility, authority, other functions and
specifically to identify periods involving a legal appointment.
3.5 Additional information can be attached in the form of letters, sworn statements
etc. You must sign each document and indicate clearly to which period the
document refers.
3.6 Please include an organigram indicating your degree of responsibility as shown in

the example below.
Applicant’s senior

Applicant’s post (Your equivalent)
  
Support Support Support (Applicant’s sub-ordinates)
3.7 Please indicate the number of people you are responsible for within the
organisation and the budget which you control, if applicable.
3.8 No other report, form or curriculum vitae will be accepted as a substitute for
Forms D2.1 & D2.2.
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Form D3
PROFESSIONAL CERTIFICATED ENGINEERS
…………………………………………………………….. ………………………………
Name of Referee Date
Address: ……………………………………………………………………..
……………………………………………………………………..
……………………………………………………………………..
Dear Sir/Madam
I have applied to the Engineering Council of South Africa for Registration as a Professional
Certificated Engineer and hereby request you to provide the Council with your evaluation of my
experience and capabilities, on the basis of your personal knowledge thereof.
Please use the attached Forms D4.1 & D4.2 and consult the guideline for referees (Sheets D4.1 &
D4.2).
In making this request to you I acknowledge that the information which will be supplied by you to ECSA
is of a confidential nature and that I have no right thereto.
Your co-operation and early despatch of the document direct to the Council would be appreciated, as it
would expedite the processing of my application.
Thank you in advance for your co-operation.
Yours faithfully
……………………………………… ……………………………………………………………
Signature of Applicant Name of Applicant (Please print)
Address:………………………………………
………………………………………
……………………………………… Postal Code: …………………….……
Telephone No: …………………………………….. Cell No: ………………………………………
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Form D4.1
REFEREE / EMPLOYER REPORT: PROFESSIONAL CERTIFICATED ENGINEERS
Please complete this form using type or print in black ink, after consulting the attached guideline (Sheets D4.1 & D4.2).
The Engineering Council of South Africa agrees that it owes a duty of confidence
to all referees in terms of the Promotion of Access to Information Act, 2000
Name of Applicant: Address: _________________________________________
__________________________________________
_________________________________________________ __________________________________________
1. General Information:
(a) My personal knowledge of the applicant's engineering training and experience and legal
appointments extends
from ___________________________ to _________________________ (month and year closely as possible).
(b) My association with the applicant was that of:
Mentor Colleague Supervisor Employer Other (Describe)

in superior
capacity
(c) Are you related to the applicant by birth or marriage? Yes:________ No:_______
If yes, please state relationship _________________________________
2. Referee’s Personal Knowledge of Applicant:

(a) Engineering experience:
From To Job description Employer
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Form D4.2
(b) Legal appointments of applicant:
Periods of legal accountability Legal appointment Brief description of responsibility
3. Referee’s Assessment of Applicant’s Competency based on:

Competency of Applicant Exceptional Above Average Below Do not know
average average
Ability to accept responsibility
Quality of work
Communication skills and abilities
Management skills
Application of technical knowledge
Application of legal knowledge
Professional conduct
Engineering judgement
Remarks: The Council would appreciate any additional remarks concerning the applicant's engineering achievements,
ability and possible limitations.
___________________________________________________________________________________________
4. Referee’s Recommendation:
I regard the applicant competent to be registered as a Professional Certificated Engineer:
Yes No No Comment Do Not Know
5. Declaration by Referee: I hereby confirm that I am conversant with the Council’s requirements for registration
as set out in Policy Statement R2/1D as well as the instructions on this referee report, and that I am prepared to
substantiate my view expressed herein at an interview, should the Council require me to do so. I also confirm that I
submit this information to ECSA on the understanding that it will be treated as confidential.
Name of Referee: ______________________________________ Title of Position held : _____________________
Qualifications: _________________________________________________________________________________
ECSA Registration Category: ______________________________________Registration No: ___________________
Employer: __________________________________________ Tel/Cell. No: ______________________________
Signature of Referee: ________________________________________ Date: ____________________________
Please post to:

 The Chief Executive Officer  Engineering Council of South Africa
Private Bag X691  BRUMA  2026
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Sheet D4.1
REFEREE GUIDELINE
for the completion of the Referee Report
Professional Certificated Engineers
1. To register as a Professional Certificated Engineer, a minimum period of three (3)

years appropriate post-Government Certificate of Competency experience, which shall
include a legal appointment as a Certificated Engineer for at least one (1) year, and
updating of competence throughout, is required. Only experience and legal
appointments, which meet the following requirements, shall be considered:
1.1 Legal appointment:
An appointment, which requires the possession of a Government Certificate of

Competency, as a Manager or as an Engineer in terms, of Regulation 2.6.1, or
Regulation 2.13.1, 2.13.3.1 and 2.13.3.2 respectively of the Mines Health and
Safety Act, 1996 (Act No. 29 of 1996), or if appointed in terms of Section 3.1(a),
4.1 or 2(a) where they are required in terms of their appointment to assume the
responsibilities of the Regulation 2.6.1 appointee requiring a GCC,_ or as an
Engineer in terms of Regulation GMR 2.1 or 2.7 of the Occupational Health and
Safety Act, 1993 (Act No. 85 of 1993) or as a Chief Engineer Officer – Foreign
Going on a vessel with a registered power of no less than 3 000 kW in terms of
the Merchant Shipping Act, 1951 (Act No. 57 of 1951), or in terms of any Act
which preceded or superseded any of the Acts mentioned above, and which
demonstrates the applicant’s competence to implement and manage the
provisions of these Acts, and ensure the safe operation and maintenance of plant
and equipment .
1.2 Experience:
Experience gained in engineering design, draughting, problem solving,

construction, training and management - project, construction, quality and
general, provided that at least two (2) of the required three (3) years of
experience are directly concerned with the installation, operation and/or
maintenance of machinery which requires sound engineering judgement, ability to
work in a team, sound communication skills and management and which
demonstrates the applicant’s competence at the required level of a certificated
engineer over the full three year period.
Experience as a mine captain / overseer / general engineering supervisor whether
with or without a legal appointment does not count as appropriate experience.
2. In the case of marine engineers, as an alternate to the specified experience above, the
following will be considered:
Experience gained as the appointed Chief Marine Engineer Officer for five (5) years, on a
variety of vessels with registered power of no less than 2 200 kW plus at least six (6)
months experience in an acting capacity as Supervising Marine Engineer, with proven
continuing updating of competence during this period, will be considered in lieu of the
experience specified above.
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Sheet D4.2
2. COMPLETING THE REFEREE REPORT
2.1 Aim
The referee report is a necessary and supplementary document to the applicant’s

application for registration as a Professional Certificated Engineer with ECSA. The aim is
to convey to the Council, on a confidential basis, the personal knowledge which the
referee or the employer has of the applicant and in the process to make a reasoned
evaluation of the applicant’s capabilities.
2.2 Motivation
It is necessary that the referee or employer be able to clearly and strongly motivate
his/her opinion in respect of the applicant’s readiness for registration. The referee must,
when supplying reasons, consider the minimum legal registration requirements.
When signing the referee report, referees declare that they are acquainted with Council’s
Policy Statement R1/1 and that they are prepared to be interviewed by the Council to
substantiate their viewpoint, should Council require them to do so.
2.3 Evaluation
The referee must carefully evaluate the applicant’s capabilities. This report is not a
character study. An evaluation of the candidate’s professional competence is required.
Referees should have a personal knowledge of an applicant and his/her work and they
should be able to give a professional opinion on his/her engineering ability, level of
engineering responsibility and professional conduct during the period of time of their
knowledge of the applicant's activities.
The referee must carefully evaluate the applicant’s capabilities and correctly and
accurately complete the report as Council attaches great value to the information, which
is supplied by the referee.
3. GENERAL
The Referee Report should be submitted directly to ECSA by the Referee and not by the
applicant. Referees are requested to have their assessments typed or to complete the
report in legible block letters using black ink to ensure clear copying, since written
assessments are frequently not very legible and to the detriment of the applicant.
4. CONFIDENTIALITY
ECSA undertakes to protect the confidentiality of all the information received from the
referee.
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Form D5
Professional Certificated Engineers
PRE-REGISTRATION PROFESSIONAL DEVELOPMENT
Name:
Discipline:
Itemise courses, workshops, conferences, symposia or congresses attended.

List these under the separate headings of engineering, management and computer courses.
Dates Duration For use of
Name or subject of item Course Provider attended in hours Assessor
__________________________________ ______________________
Signature of Applicant Date
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Page 18 of 20
Sheet D5
Information Sheet
for completion of the
Pre-Registration Professional Development Report (Form D5)
This form must be completed by all persons applying for registration as a Professional
Certificated Engineer.
1. Pre-Registration Professional Development is defined as the ongoing studies and

development of engineering knowledge required to keep abreast of new technologies. The
Registration Committee aims to gauge to what extent applicants kept abreast with
engineering and technical developments in their fields of expertise subsequent to
obtaining their qualifications.
2. Details of additional engineering courses and engineering subjects done at tertiary

institutions are required.
3. List other engineering courses, seminars, conferences, symposia, workshops etc. that
were attended. Please provide dates [year] attended and duration of the course in days or
hours. Please indicate whether you were required to sit a written examination at the
conclusion of other engineering courses. Also provide detail of papers delivered at
engineering seminars, conferences, symposia, workshops, overseas study tours, etc.
4. It is not required that copies of certificates relating to relatively minor seminars or courses
form part of the application.
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CHECK LIST
Before the Application Form is submitted to the Engineering Council please make sure that the
following points have been checked and included:
1. Application fee of R ___________________.
2. A photograph must be attached to the Application Form (Form D1.1)
3. First page of Application Form is initialled by the applicant and Commissioner of Oaths.
(Form D1.1)
4. Second page of Application Form is signed by applicant, signed and stamped by the
Commissioner of Oaths. (Form D2.2)
5. Summary of Training/Experience reports (Form D2.2) (Photocopies of the blank form may
be made)
6. Training/Experience Reports covering ALL the experience gained, completed on the form
provided (Form D2.1) (Photocopies of the blank form may be made)
7. Signatures of Applicant on each Training/Experience Report
8. Signatures of Employer on each Training/Experience Report.
9. If the applicant has his own business or signatures are unobtainable, an affidavit setting out
the reasons why no signature could be obtained, must be provided.
10. Certified copies of legal appointment, clearly stating the GMR you were appointed under as
the responsible engineer, you must have held position for a minimum period of 1 year
11. Each applicant must, with the permission of the persons concerned, supply the Council with
the names and addresses of two referees. Referees must be senior to the applicant during
the period of reference, should have personal knowledge of the applicant’s character as well
as of his engineering experience and legal appointments and be registered with ECSA as
either a Professional Certificated Engineer or a Professional Engineer. At lease one referee
MUST be a Professional Certificated Engineer and at least one referee must refer to your
current period of employment and experience. (Form D4.1 & D4.2). (Refer Sheet D1.2 of
Application Form).
12. Certified copy of G.C.C. – must have a minimum of 3 years relevant experience after
obtaining G.C.C.
13. Certified copies of certificates, diplomas, degrees, etc.
14. Organograms for the respective positions held by applicant, signed by applicant and
employer – period and position (post held) must be indicated.
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Page 20 of 20
15. Proof of membership of Institutions must be provided, where applicable.
16. Pre-Registration Professional Development Report (Form D5).
Acceptable GMR’s: 2.1, 2.7a,

GMR 16.2 & 2.9.2 is not acceptable
MINES HEALTH & SAFETY ACT (MHSA) Section 2.13.1 Eng Manager
Section 2.13.3.1 Sect Eng
Section 2.13.3.2 Assist Eng Manager
Section 2.6.1 Subordinate Manager
Section 3 (i) Mine Manager
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Page 21 of 20
DISABILITY REGISTER
Disability is defined as: “Persons with disabilities including those who have long-term physical,
intellectual or sensory impairments which in interaction with various barriers may hinder their full
and effective participation in society on an equal basis with others”.
Registration Number: ___________________________________________
Name & Surname: ______________________________________________
Do you have any disability (Please tick):
Yes No
If yes, state nature of Disability:
____________________________________________________
NB: Completion of this form is necessary in order to accurately reflect disability statistics
in terms of Employment Equity Act, No 55 of 1998 .
QM_TEM_003 Rev 0 27-11-2017

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Form No.

Subject: Registration as a Professional Certificated Engineer

Compiler: Approving Officer: Next Review Date:

Residential Address: Postal Address: Employer Name & Address:

Tel. No. (Home): Title of Position held: Tel. No. (Employer):

Cell No.: E-mail:

2. (All qualifications at tertiary level other than Government Certificates of

QM_TEM_003 Rev 0 27-11-2017

Subject: Registration as a Professional Certificated Engineer

Compiler: Approving Officer: Next Review Date:

MH&S Act – Electrical MH&S Act – Manager (Metal)

5.Previous / Current Registration or Application Details: (eg. Candidate Engineering Technologist,

My Application fee of R ___________________ is transferred electronically.

Office Use Only

Application fee: R _________

Received by: _________________________ Date: ____________________

Note: Voluntary Associations List is available on the ECSA website or http://www.ecsa.co.za

QM_TEM_003 Rev 0 27-11-2017

Subject: Registration as a Professional Certificated Engineer

Compiler: Approving Officer: Next Review Date:

Now therefore I further declare explicitly to the following:

Item Description Yes No

Commissioner of Oaths/ Justice of Peace:

QM_TEM_003 Rev 0 27-11-2017

Subject: Registration as a Professional Certificated Engineer

Compiler: Approving Officer: Next Review Date:

(ii) Please submit complete information.

Please note the following:

2. Qualifications: Original certified copies of your qualification certificate(s) leading up to attainment of

QM_TEM_003 Rev 0 27-11-2017

Subject: Registration as a Professional Certificated Engineer

Compiler: Approving Officer: Next Review Date:

QM_TEM_003 Rev 0 27-11-2017

Subject: Registration as a Professional Certificated Engineer

Compiler: Approving Officer: Next Review Date:

6. Membership of recognised Voluntary Associations: A list of associations recognised by Council is available

7. Application and Annual Fees:

QM_TEM_003 Rev 0 27-11-2017

Subject: Registration as a Professional Certificated Engineer

Compiler: Approving Officer: Next Review Date:

“Despite subsection (2), the Council may refuse to register an applicant -

QM_TEM_003 Rev 0 27-11-2017

Subject: Registration as a Professional Certificated Engineer

Compiler: Approving Officer: Next Review Date:

Surname and Initials: ________________________________________________________________________

Act: _____________________________________________________ Regulation: _______________________

Signature of Applicant: ______________________________ Date: ____________________

QM_TEM_003 Rev 0 27-11-2017

Subject: Registration as a Professional Certificated Engineer

Compiler: Approving Officer: Next Review Date:

Surname and Initials of Applicant: __________________________________________________________________

Signature of Applicant: ___________________________________ Date: _______________________________

QM_TEM_003 Rev 0 27-11-2017

Subject: Registration as a Professional Certificated Engineer

Compiler: Approving Officer: Next Review Date:

1. To register as a Professional Certificated Engineer, a minimum period of three (3) years

1.1 Legal appointment:

An appointment, which requires the possession of a Government Certificate of

Experience gained in engineering design, draughting, problem solving,

Received by: _____ Date:

Act: _______________________________ Regulation: _

Signature of Applicant: __________ Date:

Signature of Applicant: _____ Date: _

from ___ to _ (month and year closely as possible).

Name of Referee: __________________ Title of Position held : _

ECSA Registration Category: ____________________Registration No: _

Employer: ____________ Tel/Cell. No:

Signature of Referee: ____________ Date: