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Petunjuk Pengisian Form ACPE
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INFORMASI PENGISIAN APLIKASI ASEAN CHARTERED PROFESSIONAL ENGINEER
INDONESIA MONITORING COMMITTEE 2012
Dapat diunduh dari situs IMC, http://imc.or.id/
SYARAT ASEAN CHARTERED PROFESSIONAL ENGINEER (ACPE) Tamatan dari pendidikan tinggi teknik yang program studinya telah terakreditasi oleh
lembaga kewenangan di negaranya;
Memiliki Sertifikat Keahlian (SKA) dan terdaftar di negaranya sebagai Tenaga Ahli yang berhak untuk berpraktek independen;
Pengalaman kerja minimum 7 tahun setelah tamat pendidikan tinggi S-1;
Berpengalaman sedikitnya selama 2 tahun mengelola pekerjaan keinsinyuran yang berbobot (in responsible charge of significant engineering works);
Memenuhi persyaratan program pemutakhiran keprofesiannya (Continuing Professional Development, CPD) pada tingkat yang memadai untuk perpanjangan masa berlaku sertifikat; dan
Setuju untuk terikat/mematuhi kode tata laku dan kode etik profesional.
SYARAT PENDAFTARAN ASEAN CHARTERED PROFESSIONAL ENGINEER (silakan digunakan sebagai check list)
1. Form APP 01 (surat aplikasi) asli & ditandatangani;
2. Form APP 02 (portofolio, min. 2 tahun) asli & ditandatangani;
3. Form APP 03 (pernyataan) asli & ditandatangani;
4. Fotokopi ijazah S-1 dan pendidikan tinggi selanjutnya bila ada;
5. Fotokopi Sertifikat Keahlian (SKA) yang masih berlaku;
6. Berkas pengalaman kerja (CV) dalam bahasa Inggris asli dan terbaru;
7. Fotokopi KTP;
8. Pasfoto 1 buah, 4 x 6 cm.
IMC SecStamp
KHUSUS APP 02
Untuk memudahkan penilaian, Anda diminta untuk melengkapi form APP 02 dengan
diagram struktur organisasi (accountability diagram) pada kertas ukuran A4.
Diagram tersebut harus menggambarkan hal berikut:
Posisi Anda (ditandai dengan anak panah);
Dua atau tiga tingkat di atas posisi Anda;
Semua tingkatan di bawah posisi Anda;
Cantumkan pula rekan kerja Anda yang mempunyai SKA berikut kualifikasinya.
Diagram tidak berwarna agar tetap jelas apabila difotokopi / dipindai.
Contoh diagram struktur organisasi
CATATAN: Berkas aplikasi dapat diisi dengan program pengolah kata dengan ukuran font
minimum 12 atau ditulis tangan (huruf cetak); Berkas aplikasi tidak perlu dijilid ataupun diapit (staple) karena aplikasi Anda akan
perlu difotokopi / dipindai, silakan gunakan binder clips / clear sleeves / business file.
Terima kasih.
[nama perusahaan][nama proyek][periode kerja]
Sosok AxDeputy Division Manager
ANDAProject Manager
Sosok TpM/E Manager
Sosok ZaDivision Manager
Sosok PsQuality Control
Sosok WsConstruction Manager
Sosok LmLogistic Manager
Sosok LSafety Officer
Sosok GhTechnical Manager
IMC SecTypewriter* Berkas aplikasi dan kelengkapannya dapat dikirimkan softcopy-nya terlebih dulu ke alamat e-mail: secretariat@imc.or.id dengan subject/hal Aplikasi ACPE.
Terima kasih.
A P P 0 1
APPLICATION FOR A PROFESSIONAL ENGINEER TO BE REGISTERED AS ASEAN CHARTERED PROFESSIONAL ENGINEER (ACPE)
(To be completed by Applicant in BLOCK LETTERS) Name :
Name to be put in certificate:
Address :
Tel. No.: Fax No.:
E-mail:
Identity Card No.: Date of Birth: First Degree / University:
Discipline of Engineering:
Graduate Engineer Registration No.:
Date of Registrations: Professional Engineer Registration No.:
Date of Registrations:
Branch of Engineering: Discipline for ACPE Registration (select 1 discipline only): Mechanical Electrical Chemical Physic Aeronautical Marine Tech Industrial Environmental Petroleum Mining Geodetic Civil Structural Geotechnical Water Resources Transportation I enclose herewith * money order / bank draft / cheque no. : for the
amount of Rp. being the fee.
Date of previous application: (Write NIL if not applicable) Date:
(. . . .) *delete whichever is not applicable (signature)
rev 02
PC01Text BoxNama lengkap
PC01Text BoxNama yang akan dicantumkam pada sertifikat ACPE
PC01Text BoxAlamat lengkap sesuai KTP dilengkapi dengan kode pos
PC01Text BoxWajib diisi dengan jelas
PC01Text Boxdata pendidikan Strata 1 saja, pendidikan lebih lanjut cukup dilampirkan fotokopi ijazahnya
PC01Text BoxNomor Registrasi SKA (nomor yang berada di dalam kotak, cukup salah satu saja)
PC01Text BoxKlasifikasi dan Kualifikasi sesuai SKA dalam Bahasa Indonesia(salah satu saja, lainnya cukup dilampirkan fotokopinya saja)
PC01Line
PC01Line
PC01Line
PC01Text BoxNIL (untuk pendaftaran perdana)
PC01Text BoxTanggal pengisian aplikasi
PC01Sign Here
PC01Text Boxtelepon genggam / rumah
PC01Text Boxpribadi &/ kantor
PiC01TypewriterINFORMASI PENGISIAN APLIKASI ACPE, APP 01
IMC SecText BoxTanggal penetapan SKA
A P P 0 2
rev 02b APP-02, Page of
PORTOFOLIO FOR THE APPLICATION AS ASEAN CHARTERED PROFESSIONAL ENGINEER Name:
PROFESSIONAL EXPERIENCE IN RESPONSIBLE CHARGE OF SIGNIFICANT ENGINEERING WORK A B C EXPERIENCE AREA (in months) E
D1 D2 D3 D4 D5 Date (month & year)
relating to each
appointment
Example: April 87 to January
97
State concisely title of position held, name of employer, location and description of each work (make statement brief and concise, designating each work upon which
engaged with or change of position separately: include some indication of magnitude and complexity of work in which engaged, your duties and degree of responsibility)
(if necessary additional sheets may be attached)
Name, position and address of
professional engineer
under whom served &
contact no.
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Signature of any professional engineers
who has personal knowledge of applicants training or experience in
the period mentioned
Total Months
IMC SecCalloutKolom ADiisi bulan dan tahun dari awal pekerjaan hingga akhir/selesainya proyek.
IMC SecCalloutKolom BUraikan selengkap mungkin informasi mengenai pekerjaan, nama proyek, lokasi, nilai proyek, lingkup dan kompleksitas pekerjaan, serta besarnya tanggung jawab Anda dalam proyek tersebut.
IMC SecCalloutKolom CUraian kepada siapa Anda bertanggung-jawab, disertai informasi jabatan & nomor telepon yang bersangkutan.Lampirkan struktur organisasi proyek.
IMC SecCalloutJumlah total harus lebih dari 24 bulan.
IMC SecText BoxKolom D1 - D5 Diisi dengan jumlah bulan keterlibatan Anda dalam bagian pekerjaan proyek.
IMC SecCalloutKolom EDiisi dengan tanda tangan dan nama rekan kerja (insinyur profesional) yang dapat memberikan informasi mengenai keterlibatan Anda dalam proyek tersebut.
IMC SecLine
Appendix D-IV ASEAN Mutual Recognition Arrangement on Engineering Services
D. Example IV
DETAILED DESCRIPTION OF TWO YEARS EXPERIENCES IN RESPONSIBLE CHARGE OF SIGNICANT ENGINEERING WORK
Concerning "Experiences in the execution of engineering work under complicated conditions, or engineering work requiring new concepts, or engineering work involving a plurality of different disciplines", the contents of more realistically presumed experiences are described below.
1. Experiences as chief or higher-position engineer (not in assisting engineer position) in charge of engineering work executed under complicated conditions.
Complicated conditions The site is topologically complicated. Other structures are located close to the planned structures. There are strict safety and environmental requirements. The construction schedule is tight. There are many authorities concerned among which
coordination is required. Public relations are difficult.
2. Experiences as chief or higher position engineer (engineer not in
assisting position) in charge of engineering work requiring new concepts. New concept New technologies New working methods New solutions New techniques
3. Experiences as chief or higher-position engineer (engineer not in
assisting position) in charge of engineering work involving a plurality of different disciplines. Engineering work requiring expertise covering various
disciplines; Engineering work in which a plurality of different disciplines is
involved or engineering work requiring coordination among the engineers of different disciplines.
4. Experiences in engineering work equivalent to 1 through 3 above.
A P P 0 3
rev 02a Page 3 of 3
DECLARATION FOR THE APPLICATION AS ASEAN CHARTERED PROFESSIONAL ENGINEER
I hereby declare that:
I have had years of practical experience in engineering.
YES NO
I am a Professional Engineer
I meet the entire requirement as stated in Article 3 of the
ASEAN Mutual Recognition Arrangement (MRA)
No disciplinary action have been taken against me
I am not a bankrupt
Others:
Yours Sincerely,
(signature)
Name:
PE Reg. No.:
Date: Note: Please tick () in the relevant box.
PC01CalloutTotal pengalaman kerja (tahun) setelah kelulusan S1
PC01Accepted
PC01Accepted
PC01Accepted
PC01Accepted
PC01Text BoxSilakan cantumkan antara lain keanggotaan / jabatan Anda dalam organisasi profesi lainnya, dari dalam negeri ataupun luar negeri.
PC01Sign Here
PC01Text BoxNomor registrasi SKA
PC01Text BoxTanggal pengisian aplikasi
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