Proof of Identification Form (updated September 13, 2022)
Instructions to applicant:
1.
2.
3.
Fill in all of the required fields below
Attach a photocopy of any Government issued photo ID (identification), signed and dated by your guarantor.
Send the form through regular mail along with the signed photocopy of your photo identification to the APEGS office
(EMAILED or FAXED FORMS ARE NOT ACCEPTABLE).
The following people may be a guarantor:
•
•
Notary Public (this includes Lawyers) from any country
Canadian P.Eng. or P.Geo.
•
APEGS staff member
Click on the shaded boxes to complete each form field
A. Application Type
Engineer/Geoscientist-in-Training:
Professional Member:
Engineering/Geoscience Licensee:
Temporary Licensee:
B. Applicant Personal Information (as on photo identification document)
First Name:
Last Name:
Date of Birth:
APEGS File#:
Applicant Signature:
Date:
C. Photo Identification Document
Document Title:
Document #:
Country of Issue:
Date Issued:
Attach a photocopy of the Government issued photo ID (identification) indicated above.
The guarantor must write the following statement in his/her own hand writing on the photocopy of your identification (in
whichever language they prefer):
I do hereby certify that I have met the holder of this document in person, that this is a true copy of the original document and is
a true likeness of him/her.
The guarantor must sign (and seal, if applicable) and write the date on which it was signed.
Professional Engineers and Professional Geoscientists, please include membership number if a seal is not used.
GUARANTOR INFORMATION:
First Name:
Notary Public
Last Name:
P.Eng. or P.Geo.
APEGS Staff Member
WARNING to all applicants and guarantors—Any false or misleading statement on this form or relating to any
document in support of this application, including concealment of any material fact, may lead to refusal to issue a
license (if you are an applicant), or initiation of an investigation (if you are a member of APEGS).
Attached is an example of how to fill in and complete the Proof of ID form.
* Please do not print and/or send the example with the completed form.
Proof of Identification Form
Instructions to applicant:
1.
2.
3.
Fill in all of the required fields below
Attach a photocopy of any Government issued photo ID (identification), signed and dated by your guarantor.
Send the form through regular mail along with the signed photocopy of your photo identification to the APEGS office
(EMAILED or FAXED FORMS ARE NOT ACCEPTABLE).
The following people may be a guarantor:



Notary Public (this includes Lawyers) from any country
Canadian P.Eng. or P.Geo.
APEGS staff member
Click on the shaded boxes to complete each form field
A. Application Type
Engineer/Geoscientist-in-Training:
X
Professional Member:
Engineering/Geoscience Licensee:
Temporary Licensee:
B. Applicant Personal Information (as on photo identification document)
First Name:
Last Name:
Jane
Date of Birth:
1983/08/15
Applicant Signature:
hand-written signature in here,
after printing
Sample
APEGS File#:
Date:
12345
2016/10/20
C. Photo Identification Document
Document Title:
Country of Issue:
Driver’s License
Document #:
2000030
Canada
Date Issued:
2011/01/01
Attach a photocopy of the Government issued photo ID (identification) indicated above.
The guarantor must write the following statement in his/her own hand writing on the photocopy of your identification (in
whichever language they prefer):
I do hereby certify that I have met the holder of this document in person, that this is a true copy of the original document and is
a true likeness of him/her.
The guarantor must sign (and seal, if applicable) and write the date on which it was signed.
Professional Engineers and Professional Geoscientists, please include membership number if a seal is not used.
GUARANTOR INFORMATION:
First Name:
Notary Public
Last Name:
John
Doe
APEGS Staff Member
X
[
WARNING to all applicants and guarantors—Any G
false or misleading statement on this form or relating to any
document in support of this application, includingrconcealment of any material fact, may lead to refusal to issue a
license (applicant), or initiation of an investigationa(if you are a member of APEGS).
b
y the completed form.
* Please do not print and/or send this example with
o
u
r
P.Eng. or P.Geo.