FORM

COMPETENCY-BASED ASSESSMENT
EXPERIENCE RECORDS
Competency-Based Assessment Experience Records Form PROFESSIONAL ENGINEERS ONTARIO 1

February 2024
 APPLICANT INFORMATION

DATE:

PEO FILE NUMBER:

LAST NAME:

FIRST NAME:

2 PROFESSIONAL ENGINEERS ONTARIO Competency-Based Assessment Experience Records Form

 WORK EXPERIENCE EXAMPLE 1
Please provide PEO with your professional engineering experience information. You may add multiple examples of experience.

COMPANY NAME:

COMPANY ADDRESS:

START DATE:

IS THIS YOUR CURRENT ROLE? YES NO

IF “NO”, WHEN WAS THE END DATE?:

JOB RESPONSIBILITIES:

WAS THIS EMPLOYMENT COMPLETED BEFORE GRADUATION? YES NO

Competency-Based Assessment Experience Records Form PROFESSIONAL ENGINEERS ONTARIO 3

 WORK EXPERIENCE EXAMPLE 2
Please provide PEO with your professional engineering experience information. You may add multiple examples of experience.

COMPANY NAME:

COMPANY ADDRESS:

START DATE:

IS THIS YOUR CURRENT ROLE? YES NO

IF “NO”, WHEN WAS THE END DATE?:

JOB RESPONSIBILITIES:

WAS THIS EMPLOYMENT COMPLETED BEFORE GRADUATION? YES NO

4 PROFESSIONAL ENGINEERS ONTARIO Competency-Based Assessment Experience Records Form

 WORK EXPERIENCE EXAMPLE 3
Please provide PEO with your professional engineering experience information. You may add multiple examples of experience.

COMPANY NAME:

COMPANY ADDRESS:

START DATE:

IS THIS YOUR CURRENT ROLE? YES NO

IF “NO”, WHEN WAS THE END DATE?:

JOB RESPONSIBILITIES:

WAS THIS EMPLOYMENT COMPLETED BEFORE GRADUATION? YES NO

Competency-Based Assessment Experience Records Form PROFESSIONAL ENGINEERS ONTARIO 5

 WORK EXPERIENCE EXAMPLE 4
Please provide PEO with your professional engineering experience information. You may add multiple examples of experience.

COMPANY NAME:

COMPANY ADDRESS:

START DATE:

IS THIS YOUR CURRENT ROLE? YES NO

IF “NO”, WHEN WAS THE END DATE?:

JOB RESPONSIBILITIES:

WAS THIS EMPLOYMENT COMPLETED BEFORE GRADUATION? YES NO

6 PROFESSIONAL ENGINEERS ONTARIO Competency-Based Assessment Experience Records Form

 WORK EXPERIENCE EXAMPLE 5
Please provide PEO with your professional engineering experience information. You may add multiple examples of experience.

COMPANY NAME:

COMPANY ADDRESS:

START DATE:

IS THIS YOUR CURRENT ROLE? YES NO

IF “NO”, WHEN WAS THE END DATE?:

JOB RESPONSIBILITIES:

WAS THIS EMPLOYMENT COMPLETED BEFORE GRADUATION? YES NO

Competency-Based Assessment Experience Records Form PROFESSIONAL ENGINEERS ONTARIO 7

 SELF-ASSESSMENT RATING SHEET

Please attach a completed Competency-Based Self-Assessment Rating Sheet. Click here to access the CBA Application Form.
Complete a self-assessment of your abilities, as outlined in the Competency-Based Assessment Applicant’s Guide.

Assign yourself a score from 0-5, with a score of 0 representing no level of competency and 5 representing an advanced level of competency.
For a detailed breakdown of the self-assessment levels, please access the Competency-Based Assessment Applicant’s Guide (page 10).

COMPETENCY CATEGORY 1: TECHNICAL COMPETENCE

1.1 Demonstrate your knowledge and awareness of regulations, codes and standards used
in Canada, or the international standard equivalence. This includes local engineering 0
procedures and practices as applicable.

1.2 Demonstrate knowledge of materials, or operations as appropriate, project and design

constraints, design to best fit the purpose or service intended and address interdisciplinary
0
impacts.

1.3 Analyze technical risks and offer solutions to mitigate the risks.
0

1.4 Apply engineering knowledge to design solutions.

0

1.5 Be able to understand solution techniques and independently verify the results. 0

1.6 Demonstrate your knowledge and awareness of regulations, codes and standards
pertaining to safety used in Canada or the international standard equivalence. 0

1.7 Demonstrate understanding of systems as well as of components of systems. 0

1.8 Exposure to all stages of the process/project life cycle from concept and feasibility analysis
through implementation.
0

1.9 Demonstrate your understanding of the role of peer review and quality management that
is essential to engineering practice in Canada.
0

1.10 T ransfer design intentions to drawings

. and sketches; Understand transmittal of design
information to design documents 0

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COMPETENCY CATEGORY 2: COMMUNICATION

2.1 Demonstrate effective verbal communication with team members, clients, contractors and
members of the public 0

2.2 Demonstrate your ability to communicate effectively in writing with team members, clients,
contractors and members of the public. 0

2.3 Demonstrate your ability to effectively review key documents.

0

COMPETENCY CATEGORY 3: PROJECT AND FINANCIAL MANAGEMENT

3.1 Awareness of project management principles. 0

3.2 Demonstrate increasing level of responsibility for project planning and implementation. 0

3.3 Manage expectations in light of available resources.

0

3.4 Understand the financial aspects of their work. 0

3.5 Ask for and demonstrate response to feedback. 0

COMPETENCY CATEGORY 4: TEAM EFFECTIVENESS

4.1 Work respectfully and with other disciplines/people. 0

4.2 Work to resolve differences. 0

Competency-Based Assessment Experience Records Form PROFESSIONAL ENGINEERS ONTARIO 9

COMPETENCY CATEGORY 5: PROJECT AND FINANCIAL MANAGEMENT

5.1 Demonstrate your ability to apply principles of the Code of Ethics, or the international
standard equivalence, within the engineering environment.
0

5.2 Demonstrate an awareness of your own scope of practice and limitations. 0

5.3 Understand how conflict of interest affects your practice. 0

5.4 Demonstrate awareness of professional accountability.

0

5.5 Demonstrate an understanding of appropriate use of the stamp and seal. 0

5.6 Understands own strengths/weaknesses and know how they apply to one’s position. 0

COMPETENCY CATEGORY 6: SOCIAL, ECONOMIC, ENVIRONMENTAL AND SUSTAINABILITY

6.1 Demonstrate an understanding of the safeguards required to protect the public and the
methods of mitigating adverse impacts. 0

6.2 Demonstrate an understanding of the relationship between the engineering activity

and the public. 0

6.3 Understand the role of regulatory bodies on the practice of engineering. 0

6.4 Be aware of any specific sustainability clauses that have been added to practice guidelines
thatapply to their area 0

6.5 To the extent possible, recognizing the applicant’s position of influence, consider how
sustainability principles could be applied and promoted in their specific work. 0

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COMPETENCY CATEGORY 7: CONTINUING PROFESSIONAL DEVELOPMENT

7.1 Demonstrate completion of professional development activities. 0

7.2 Demonstrate awareness of gaps in knowledge and areas requiring future development.
0

7.3 Develop a professional development plan to address gaps in knowledge and maintain
currency in field of practice. 0

Competency-Based Assessment Experience Records Form PROFESSIONAL ENGINEERS ONTARIO 11

 VALIDATOR INFORMATION

Please provide validator information. Ensure that your validators meet the requirements outlined in the CBA guide.
Click here to view the CBA guide. If you intend to provide more than four validators, please contact [email protected].

VALIDATOR 1:

First name:

Last name:

Which competencies will this validator attest to? Ensure that all 34 are accounted for between your validators.

Company:

Email address:

12 PROFESSIONAL ENGINEERS ONTARIO Competency-Based Assessment Experience Records Form

VALIDATOR 2:

First name:

Last name:

Which competencies will this validator attest to? Ensure that all 34 are accounted for between your validators.

Company:

Email address:

VALIDATOR 3:

First name:

Last name:

Which competencies will this validator attest to? Ensure that all 34 are accounted for between your validators.

Company:

Email address:

Competency-Based Assessment Experience Records Form PROFESSIONAL ENGINEERS ONTARIO 13

VALIDATOR 4:

First name:

Last name:

Which competencies will this validator attest to? Ensure that all 34 are accounted for between your validators.

Company:

Email address:

VALIDATOR 5:

First name:

Last name:

Which competencies will this validator attest to? Ensure that all 34 are accounted for between your validators.

Company:

Email address:

14 PROFESSIONAL ENGINEERS ONTARIO Competency-Based Assessment Experience Records Form

 DECLARATION

I declare that the information provided is true and complete to the best of my knowledge. I understand that a false statement or misrepresentation may
disqualify me for a licence. I agree to provide additional information and documentation as requested from time to time by PEO and/or if the response to
any question on this application changes between now and the date of my licensing as a professional engineer in Ontario.

Professional Engineers Ontario shares relevant applicant/practitioner information with other licensing bodies, including North American professional
engineering licensing bodies, pursuant to the PEO Privacy Policy and the Memorandum of understanding on Discipline and Enforcement for Associations/
Order of Professional Engineers in Canada and the Agreement on Mobility of Professional Engineers within Canada.

I agree

Date:

Signature:

Competency-Based Assessment Experience Records Form PROFESSIONAL ENGINEERS ONTARIO 15