Ministryy of Municipaality & Urban Planning

Engineers & Consultiing Offices Acccrediting Coommittee

Date:_____________________ Form (4)

(4) _____________________ :

Enrollment

at Engineers Register

Photo

Personnal Data
Nationaality
Passporrt No.

P.O. Box
.
(1)

Full Name
ID No.

Sponsoor name
For residents
Resideency validity datte
only
Sponsoor's commercial registration Noo., if available
Mobile
Tel.
Fax
E-Mail (2)
(
(2) E-Mail (1)
Qualifications and exxperiences

Graduation year
country

Univeersity or collegge

Requireed specialty
Currentt employer

Specialty

Total years of experieence

Applicaant acknowledgment

Honoor degree
No.
1
2
3

I, the unddersigned confirm

m that the above mentioned data andd enclosed docum
ments are

correct and
a conform to auuthenticity. I also,, officially acknow
wledged the provi sions of
2005 ( 19)

Law No. (19) of the yeaar 2005 concerninng regulating thee practice of engiineering


professioons and its impplementing regulaations. I also, acknowledged
a
thaat after
( ..... )
submittinng application to committee or havving the interview, I would not provvide any
.
further documents
d
(qualifiications or experieence certificates, trraining courses, etcc.)

Applicaant signature

Enclosuures

Vaalid Qatari ID card

Notarized qualificatiions certificates by Foreign Ministry inn Doha.

Exxperience certificattes certified by com

mpetent parties and by Foreign Minisstry
inn Doha.

Good conduct certifiicate issued by the State of Qatar.

Fill in the attached engineer spreadsheeet.

Coopy of passport.

Curriculum Vitae.

Trraining courses.

Leetter issued by Ministry of Labor staating that applicantt doesnt work at aany
goovernmental bodies or ministries or att any public entitiess. (for Qataris only))

10

Any other data or doocuments.

.



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(
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For official use only

Applicaation received oon

Recipieent signature

1
2
3
4
5
6
7
8
9
10

Appliication No.
Recippient name
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