Accredited Checker Form PDF
Accredited Checker Form PDF
Accredited Checker Form PDF
No………..
THE REGISTRAR
ENGINEERS BOARD OF KENYA
P. O. BOX 30324-00100
NAIROBI
Surname ………………………………………………………………...………..………………….
Nationality ……………………………………….……………………………....………………….
Discipline ………………………………………………………….…………..…..……………….
…………………………………………………..…………………………………..……………….
EBK/R&L/F/04
EDUCATION:
Note:- The application must be a accompanied by two coloured Passport Size Photos, certified copies of
the original Diploma/Degree Certificate, Engineers Board of Kenya Certificate, Corporate Member IEK
and a copy of the National ID/Card or Passport all duly certified by a Commissioner of Oaths whose
names and address are fully displayed on the Rubber Stamp.
SPECIAL QUALIFICATIONS:
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EXPERIENCE:
I submit below my experience in a chronological order including the name and address of each
employer and description of projects carried out. (A separate sheet may be used if necessary). This
should be certified by one of the referees named below.
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EBK/R&L/F/04
REFERENCE:
I append the names and addresses of three Consulting Engineers, to whom reference may be made
regarding my experience and character.
1. …………………………………………………………………………………………………..
2. …………………………………………………………………………………………………..
3. …………………………………………………………………………………………………..
An applicant’s supervisor should be listed as one of the referees. The Referees must be Registered with
the Board as Professional Consulting Engineers with current valid annual licences.
1. I attach my application fee of Kshs. 25,000 payable to the Engineers Board of Kenya which I
understand is not refundable.
2. I hereby declare that the foregoing statements are true in every respect and that I have read the
Engineers Act, 2011 and understood that, if registered as an accredited checker, I shall be bound
thereby and by any amendments thereto so long as my name remains on the Register of
Accredited Checkers.
Signature of applicant ………………………………….
Date..…………………………………………………..
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Deposit receipt No ……………………… Date of Registration ………………..…….
For office
Use only.
Registration Number ……………..… Candidate notification date …….…….……