CO

MPE

TEN

CY

DEM

ON

STRA

TIO

N R

EPO

RT

This pathway applies to persons who hold a non-recognised qualification. An Engineering qualification at least equivalent to an Australian (AQF) Advanced Diploma (two years of engineering study following twelve years of schooling) must be held by the applicant before an application may be made. This pathway also applies to persons seeking assessment who:• Holdanengineering-relateddegree(eg,Chemistry,Physics)andhavebeenemployedasanengineer

forthreeyearsormore(fulltimeequivalent);or• Holdanaccreditedengineeringqualificationbutareseekinganoutcomeinadifferentoccupational

fieldtothatofthedegreespecification;or• AreseekingassessmentasanEngineeringManager.

PErsonAl DETAils (PlEAsE usE block lETTErs AnD Tick ThE APProPriATE boxEs bElow)

Title: Prof Dr Mr Mrs Ms Miss Other (pleasespecify)......................................

Family Name: .................................................................................................................................................................................

GivenNames(infull):.................................................................................................................................................................

DateofBirth:........../........../.......... CountryofBirth............................................. Gender: Male Female

Applicant’sCurrentAddress:....................................................................................................................................................

City:.................................................................. Country:..................................................................Postcode:.......................

Phone: ......................................................................................... Mobile:..................................................................................

Email: ................................................................................................................................................................................................

YournominatedEngineeringoccupation:...........................................................................................................................

Countryofqualifications:..........................................................................................................................................................

Indicateoccupationalcategoryforwhichyouareapplying:

Professional Engineer EngineeringAssociate

EngineeringTechnologist Engineering Manager

Applicant’s Signature: ................................................................................................. Date: ........./........../..........

note:ApplicantsMusTcopyallsubmittedmaterial-documentssubmittedwillnoTbereturned.

daymonthyear

PAGE 1 of 3

Application for Migration skills Assessment coMPETEncy DEMonsTrATion rEPorT (cDr)(All Engineering categories)

Pleaseaffixa passport size

photograph here

credit card Details Pleasechargecreditcard(tickone) AmericanExpress Visa Mastercard

CreditCardNo:

Cardholder’sName:.................................................................................................................. ExpiryDate:.........../...........

Amount:AUD$........................ Cardholder’sSignature:............................................... Date:.........../............/...........

METhoD oF PAyMEnT (PlEAsE Tick ThE APProPriATE boxEs bElow)

Assessment specification Applicants living overseas Applicants living in Australia

Fees (GsT exc.) Tick(s) Fees (GsT inc.) Tick(s)

StandardCDRassessment AUD$600 AUD$660

RelevantSkilledEmployment AUD$250 AUD$275

OverseasPhD AUD$200 AUD$220

Total Payment AuD $ AuD $

Thismustbepaidatthetimeoflodgementofthisformandcompleteddocumentation. The fee is noT refundable.The Payee is EnGinEErs AusTrAliAforpaymentsmadeusingcheque,moneyordersandbankdrafts.OverseasapplicantsusingthisformofpaymentMusTensurethatthebankdraftisdrawninAustralian Dollars onlytoabankoperatinginAustralia.

BankDraft/MoneyOrderdrawntoanAustralianbankinAustraliandollars

Cheque AustralianMoneyOrder CreditCard(seebelow).

daymonthyear

Office use only CID

daymonthyear

month year

Mail to: Migration skills Assessment, Education and Assessment, Engineers Australia, 11 national circuit, bArTon AcT 2600 Australia

cErTiFicATion oF coPiEs oF DocuMEnTs

Properly-certified copies of oriGinAl documents are required. certified copies of previously certified copies will not be accepted.

Propercertificationshouldappearoneachpagetobecertified,andshow:• Thesignatureofthepersoncertifyingthedocument• Thenameofthepersoncertifyingthedocument–clearlyprintedorevidentintheofficialstamp• contact detailsofthepersoncertifyingthedocument• Wherepossibleanofficialstampindicatingthestatusofthepersoncertifyingthedocument,ie:

JusticeofthePeace,CommissionerforOaths,orNotaryPublic,etc,ornameoflawfirmindicated.

Thefollowingclassesofpersonsareauthorisedtocertifycopiesofdocuments:• AcurrentfinancialMemberofEngineerAustralia(otherthanattheStudentgrade).

Themembershipnumbermustbeshown• AStaffMemberofEngineersAustralia• ANotaryPublicauthorisedinthecountryofapplication• ACommissionerforOaths(Declarations)authorisedinthecountryofapplication• ALawyer,Solicitor,BarristerorJudgeauthorisedinthecountryofapplication• AJusticeofthePeaceauthorisedinAustraliaorinthecountryofapplication

Iftheservicesofalegalfirmareemployed,thenameofthesolicitorcertifyingthedocumentsmustbeprovided.Itisnotsufficienttosimplyprovidethenameofthelawfirm.

Application for Migration skills Assessment coMPETEncy DEMonsTrATion rEPorT (cDr)(All Engineering categories) (continued)

PAGE 2 of 3

APPoinTMEnT oF A PErson To AcT As AGEnT

Agent’sName:................................................................................................................................................................................

Agent’sAddress:.............................................................................................................................................................................

..............................................................................................................................................................................................................

Agent’sRegistrationNumber(ifapplicable):......................................................................................................................

Agent’sPhone:...............................................................................................................................................................................

Agent’sEmail:................................................................................................................................................................................

Visit us at www.engineersaustralia.org.au

if you are using an Agent, then you must complete this part of the form. otherwise, leave blank.note: All correspondence will be sent to the Agent’s address entered below

I,.................................................................................................................................................................... (applicant’sname)

of(address):....................................................................................................................................................................................

City: ....................................................................................................................................................................................................

Postcode:........................................................................... State/Territory/District: ......................................................

Country:.............................................................................................................................. bornon:........../........../..........

agreetothefollowingpersonactingonmybehalfinrelationtomyapplicationforassessment.

Applicant’s Signature: ............................................................................................................ Date:........./........../..........daymonthyear

daymonthyear

CO

MPE

TEN

CY

DEM

ON

STRA

TIO

N R

EPO

RT

DEclArATion

chEcklisT

The competency Demonstration report (cDr) submission MusT include the applicant’s endorsement of the following Declaration:

‘All statements of fact in this report are true and correct, and I have made claims of acquired competencies in good faith.

The Report is all my own work, and is a true representation of my personal competencies in written English.

I confirm that I understand that members of the engineering team in Australia are required to display a commitment to exercising professional and ethical responsibility in all aspects of their work.

I also understand that documentation submitted in support of my application may be referred to the Australian Department of Immigration and Citizenship (DIAC) for integrity checking’

Application for Migration skills Assessment coMPETEncy DEMonsTrATion rEPorT (cDr)(All Engineering categories) (continued)

PAGE 3 of 3

PrintedName:.................................................................................................................................................................................

Signature: .................................................................................................................................... Date:........./........../..........daymonthyear

CO

MPE

TEN

CY

DEM

ON

STRA

TIO

N R

EPO

RT

CM0612

Beforeyoudispatchyourapplicationyoushouldusethefollowingchecklisttoensurethatyouhavecompletedallthenecessarystepsandprovidedalltherequireddocuments.Assemble your submission by placing documents in the order shown below.Pleasedonotbindyourdocuments.

checklist for competency Demonstration report (cDr)

CompletedApplicationForm,withpassport-stylephoto

Applicationfee

Formtoappointpersontoactasagent[ifnecessary]

Certifiedtruecopyofpassportbio-datapageonly(notthecompletepassport),andEnglishlanguagetranslation(ifnotEnglish)[Wherethisisnotavailable,acopyofyourBirthCertificateand/orNationalIdentityCardmaybeacceptableinlieu]

Certifiedtruecopyofnamechangedocument[ifnecessary]

OriginalEnglishlanguagetest(IELTS)result[ifnecessary].YoumustarrangethistobeforwardeddirectlytoEngineersAustraliafromtheTestCentre.

CurriculumVitae(CV)/Resume

Certifiedtruecopyofacademictestamur(s).

Certifiedtruecopiesofacademictranscripts(s)

Certifiedevidenceofregistrationundertherelevantlicensingauthorityinthecountryinwhichyouarepractising[ifnecessary]egPhilippineRegulationsCommission

Certifieddocumentaryevidenceofemployment[mustbeprovidedifyouhaverelevantworkexperienceof12monthsormore,oriftheworkexperienceprovidesabasisofacareerepisode(s)]

AnaccountofContinuingProfessionalDevelopment(CPD)

CDRDeclarationPage

ThreeCareerEpisodes

SummaryStatementofevidenceforthecompetencyelements

Englishlanguagetranslationsofabove,whereapplicable

RelevantSkilledEmployment(OptionalService);periodofemployment,jobtitle,mainfive(5)duties,fullorpart-time(hours/week)

OverseasPhD(OptionalService);CertifiedcopyofPhDtestamur,thesisabstract,listofexaminers,listofpublications

Visit us at www.engineersaustralia.org.au