Form ENLS-651-015 "Professional Engineer Registration Application" - Washington

What Is Form ENLS-651-015?

This is a legal form that was released by the Washington State Department of Licensing - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2019;
  • The latest edition provided by the Washington State Department of Licensing;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form ENLS-651-015 by clicking the link below or browse more documents and templates provided by the Washington State Department of Licensing.

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Download Form ENLS-651-015 "Professional Engineer Registration Application" - Washington

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Click here to START or CLEAR, then hit the TAB button
Professional Engineer
Registration Application
Apply for a Professional Engineer license in Washington.
Fees are non-refundable.
https://professions.dol.wa.gov
Online:
Or by mail with a check or money order payable to Department of Licensing:
Professional Engineers and Land Surveyors
Department of Licensing
PO Box 3777
Seattle WA 98124-3777
For questions or language help call: (360) 664-1575
Application type
(check one)
by Exam – $65
by Comity (if you have a current license in another state) – $110
Licenses are available for self-printing with an online account.
If you want us to print and mail your license add a $5 print fee for each copy to your payment.
$0 self-print license online.
$5 each. DOL print and mail license. Quantity
Total $
Applicant
TYPE or PRINT Name as you would like it to appear on your license
Full legal name (First, Middle, Last)
Social Security number* (or ITIN, Green Card, Canadian SIN)
Date of birth
Military? (check if applicable)
Current or former:
Military member
Military spouse or domestic partner
Mailing address
City
State
ZIP code
(Area code) Contact phone number
Email
Branch of engineering
*
You are not required to have a Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN or TIN) to apply for or be issued a
license. If you do not have an SSN or ITIN, leave that section blank. If you do have a SSN, ITIN or TIN, you are required by federal and state law to
provide it on the application (42 U.S.C. 666(a)(13) and RCW 74.20A.320).
Legal background
Answer the following
Answer the questions below. If you answer “Yes,” attach a detailed explanation.
1. Within the last 5 years, in this state or any other jurisdiction, have you had any action
(fine, suspension, revocation, censure, surrender, etc.) taken against any professional or
occupational license, certification, or permit held by you?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
2. Within the last 5 years, in this state or any other jurisdiction, have you defaulted, or been
convicted of, or entered a plea of no contest to a gross misdemeanor or felony crime?
(Don’t include traffic convictions.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
(continued on next page)
ENLS-651-015 (R/6/20)WA Page 1 of 2
Click here to START or CLEAR, then hit the TAB button
Professional Engineer
Registration Application
Apply for a Professional Engineer license in Washington.
Fees are non-refundable.
https://professions.dol.wa.gov
Online:
Or by mail with a check or money order payable to Department of Licensing:
Professional Engineers and Land Surveyors
Department of Licensing
PO Box 3777
Seattle WA 98124-3777
For questions or language help call: (360) 664-1575
Application type
(check one)
by Exam – $65
by Comity (if you have a current license in another state) – $110
Licenses are available for self-printing with an online account.
If you want us to print and mail your license add a $5 print fee for each copy to your payment.
$0 self-print license online.
$5 each. DOL print and mail license. Quantity
Total $
Applicant
TYPE or PRINT Name as you would like it to appear on your license
Full legal name (First, Middle, Last)
Social Security number* (or ITIN, Green Card, Canadian SIN)
Date of birth
Military? (check if applicable)
Current or former:
Military member
Military spouse or domestic partner
Mailing address
City
State
ZIP code
(Area code) Contact phone number
Email
Branch of engineering
*
You are not required to have a Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN or TIN) to apply for or be issued a
license. If you do not have an SSN or ITIN, leave that section blank. If you do have a SSN, ITIN or TIN, you are required by federal and state law to
provide it on the application (42 U.S.C. 666(a)(13) and RCW 74.20A.320).
Legal background
Answer the following
Answer the questions below. If you answer “Yes,” attach a detailed explanation.
1. Within the last 5 years, in this state or any other jurisdiction, have you had any action
(fine, suspension, revocation, censure, surrender, etc.) taken against any professional or
occupational license, certification, or permit held by you?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
2. Within the last 5 years, in this state or any other jurisdiction, have you defaulted, or been
convicted of, or entered a plea of no contest to a gross misdemeanor or felony crime?
(Don’t include traffic convictions.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
(continued on next page)
ENLS-651-015 (R/6/20)WA Page 1 of 2
Applicant name
Certification
Answer the following
1. Are you having a NCEES experience record sent? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If yes, please provide NCEES record number:
2. Do you authorize any business associates (past and present) and any governmental agencies
(local, state, or federal) to release to the Department of Licensing any information, files, or records
which may be required for a background investigation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
3. Do you understand that if you provide any false information in this application we may deny,
suspend, or revoke your license to practice in Washington? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Education
Name and location of colleges, universities,
Dates of attendance
technical schools attended
From
To
Curriculum
Degree/ Date
Previous and current registration
Answer the following
Written FE exam in state of
NCEES exam?
Yes
No
Written PE exam in state of
NCEES exam?
Yes
No
• Go online to
account.ncees.org
and follow the instructions to request license/exam verification.
• If your state board is not listed on this site, contact them to request verification be sent to us.
Experience record summary
List all of your employers beginning with the most recent. You must account for all time since leaving college (if applicable)
or beginning your engineering career to now. You must also include periods while unemployed, or non-engineering work.
Attach additional sheets if necessary.
• For full time employment of 32 or more hours/week indicate “FT”. For part time under 32 hours/week indicate “PT”.
• If the work is not to be verified, indicate “No”. Any experience not verified will not be counted toward the experience requirement.
Time period
Full time or
To be verified?
(begin with most recent)
From
To
Employer
part time?
(month-year)
(month-year)
(yes or no)
1
2
3
4
5
6
7
I declare under penalty of perjury under the law of Washington that the foregoing is true and correct.
TYPE or PRINT Name
X
When you have completed this form, please print it out and sign here.
Date and place
Applicant signature
Providing any false information in this application may be cause for denial, suspension, or revocation of your
professional license in the state of Washington.
ENLS-651-015 (R/6/20)WA Page 2 of 2
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