PRIVATE AND CONFIDENTIAL
Application for Registration as an
Engineering Technician (EngTech)
Section 1
General Information
Surname:
First Names:
Title:
Mr
Mrs
Miss
Ms
Other ______
Date of Birth:
Home Address
Work Address
Postcode:
Postcode:
Telephone:
Telephone:
Mobile:
Mobile:
E-mail:
E-mail:
Mail should be sent to:
Home Address
School Leaving
Work Address
Further Education
Apprenticeship
Other Formal Training
Institution:
Qualification:
Subject(s):
Class:
Year:
Additional
Information:
Give details of formal work-based training you have received from an accredited training provider, giving start and finish dates,
credentials of the training provider and the engineering and technical content of the training. Give details of informal training and
experiential learning, giving learning outcomes. Give details of other professional memberships.
If necessary, continue on a separate sheet, clearly labelled with your name and continuation point.
Present Appointment:
Employer:
Current Grade:
Date Appointed:
Specialist Area:
IPEM Membership:
I am already an
Associate Member
Full Member
M/Ship Number:
]
I wish to apply for Associate Membership concurrently with EngTech
(please choose one)
Previous relevant employment:
Include details of all previous relevant employment on a Curriculum Vitae attached to this application form. Set out, in chronological order, the dates
and designations of all posts held, giving with each one the name of the employer, the place of employment, and a brief description of your duties and
responsibilities, which will inform the Registrars and Assessors of your personal contribution and the way in which you have applied your engineering
and technical education, training and experience.
Section 2
Assessment of competences
[Based on the latest UKSPEC EngTech Engineering Technician Standard]
Document 0207 v03.00 issue 03-09-2014
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PRIVATE AND CONFIDENTIAL
Provide evidence indicating how you satisfy the criteria shown below. A short paragraph in response to each numbered
competence requirement shown, together with supporting evidence, if relevant, is all that is required. Your responses and
supporting evidence must be clearly marked, showing to which section of the standard they are applicable. There will be
pointers in italics to help you.
Engineering Technicians must be competent throughout their working life, by virtue of their
education, training and experience to:
A Use engineering knowledge and understanding to apply technical and practical skills in the
field of medical engineering.
The reviewers will be looking for evidence that you have the know-how to do the job, and were able to go beyond the
immediate requirements and use your initiative and experience to solve a problem or improve a process.
This includes the ability to:
A1
review and select appropriate techniques, procedures and methods to undertake
tasks;
(Describe:
• an example of work you did that went well, the choices you made and the outcome
• or something in your work that you were involved in which didn’t quite work and explain why
• or a technique, procedure or method you improved upon and explain why)
A2
use appropriate scientific, technical or engineering principles.
(Drawing from your direct experience in a medical engineering field, this might be an explanation of how a
piece of equipment, system or mechanism works)
B Contribute to the design, development, manufacture, construction, commissioning,
operation or maintenance of products, equipment, processes, systems or services in the
medical field.
Explain how you contribute to one or more of these activities.
In this context, this includes the ability to:
B1
identify problems and apply appropriate methods to identify causes and achieve
satisfactory solutions;
(Show an example of how you have used measurement, monitoring and assessment to:
• identify the source of a problem
• or to identify an opportunity
• or to propose a solution)
B2
identify, organise and use resources effectively to complete tasks, with
consideration for cost, quality, safety, security and environmental impact.
(Illustrate how you make decisions about:
• what information, material, component, people or plant to use
• or how to introduce a new method of working
• or what precautions you took
Describe how you have contributed to best practice methods of continuous improvement, eg ISO 9000)
C Accept and exercise personal responsibility.
Describe an experience or instance where you have had to accept personal responsibility for seeing a process
through to completion within agreed targets.
This may include the ability to:
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Name of candidate
C1
PRIVATE AND CONFIDENTIAL
work reliably and effectively without close supervision, to the appropriate codes of
practice;
(Your evidence should show how you identified and agreed what had to be done and to what standards
on a typical project).
C2
accept responsibility for work of self and others;
C3
accept, allocate and supervise technical and other tasks.
(Your evidence could include:
minutes of meetings; site notes and instructions; Variation Orders; programmes of work; specifications,
drawing and reports; or appraisals. Activity not associated with your job can contribute evidence).
D Use effective communication and interpersonal skills.
You will need to show you can: contribute to discussions; make a presentation; read and synthesise
information; write different types of documents.
This includes an ability to:
D1
use oral, written and electronic methods for the communication in English of
technical and other information;
(Your evidence could include: letters; reports; drawings; emails; minutes, including of progress meetings;
appraisals; work instructions; and other task planning and organising documents. Your application itself
will be relevant).
D2
work effectively with colleagues, clients, suppliers or the public, and be aware of the needs
and concerns of others, especially where related to diversity and equality.
•(Show examples of how this has occurred, and your role at the time.
•Describe your role as part of a team.
•Describe a situation where you put your awareness into practice).
E Make a personal commitment to an appropriate code of professional conduct,
recognising obligations to society, the profession and the environment.
Your commitment will be to become part of the profession and uphold the standards to which all members
subscribe. You need to show that you have read and understood IPEM Codes of Conduct.
In order to satisfy this commitment, you must:
E1
comply with the Codes and Rules of Conduct of their Licensed Institution or
Professional Affiliate;
(The professional review involves demonstration of, or discussion of, your position on typical ethical
challenges)
E2 manage and apply safe systems of work;
(Provide evidence of applying current safety requirements, such as risk assessment and other examples
of good practice you adopt in your work. You will need to show that you have received a formal safety
instruction relating to your workplace (such as a CSCS safety test in the UK), or an update on statutory
regulations. In the UK an example would be COSHH requirements )
E3
undertake engineering work in a way that contributes to sustainable development.
This could include an ability to:
• Operate and act responsibly, taking account of the need to progress environmental, social and economic
outcomes simultaneously.
(Show examples of methodical assessment of risk in specific projects; actions taken to minimise risk to
society or the environment)
E4
carry out and record CPD necessary to maintain and enhance competence in own
area of practice including:
• Undertake reviews of own development needs
• Plan how to meet personal and organisational objectives
• Carry out planned (and unplanned) CPD activities
• Maintain evidence of competence development
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PRIVATE AND CONFIDENTIAL
• Evaluate CPD outcomes against any plans made
• Assist others with their own CPD.
(This means demonstrating that you have actively sought to keep yourself up to date, perhaps by studying
new standards or techniques, or made use of magazines, lectures organised by professional engineering
institutions, and other opportunities to network in order to keep abreast of change)
E5 exercise responsibilities in an ethical manner.
(Give an example of where you have applied ethical principles as described in the Statement of
Ethical Principles. The Statement of Ethical Principles, published by the Engineering Council
and the Royal Academy of Engineering, lists four fundamental principles to guide engineers and
technicians in achieving the high ideals of professional life:
• Accuracy and rigour
• Honesty and integrity
• Respect for life, law and the public good
• Responsible leadership; listening and informing)
(Give an example of where you have applied/upheld ethical principles as defined by your organisation or
company, which may be in its company or brand values)
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PRIVATE AND CONFIDENTIAL
Section 3
Supporting Comments
If you wish, make other comments that may support your application for EngTech on a typed A4 size sheet. Comments
should be relevant to the requirements of the Engineering Council’s UKSPEC for Engineering Technician registration.
Section 4
Organisation Chart
Produce an organisation chart for your present post, showing the line management structure immediately above and
below you, and colleagues working alongside you. Each post shown should be labelled with the position of the post
holder, and your own post should be clearly marked, giving the number of persons directly supervised by you where this
is not clear from the chart. You may also provide not more than two organisation charts relating to previous posts, which
relate to the responsible experience being offered.
APPLICANT’S UNDERTAKINGS
I wish to apply for registration as an Engineering Technician through IPEM, and Associate Membership, if not already a member of IPEM, and I declare
that the information I have given in this application is, to the best of my knowledge, accurate and true. I agree to be governed by the Rules of the IPEM,
including its Code of Professional Conduct, and accept that any breaches of the Rules or the Code of Professional Conduct will be dealt with under the
IPEM’s Disciplinary Procedure and, if serious, may result in loss of IPEM Membership and loss of registration as an Engineering Technician.
Date:
(Signature of Applicant)
PROPOSERS AND SUPPORTERS
Proposers should where possible be Fellows or Members of IPEM. If not they should be members of a similar organisation.
We, the undersigned, propose the candidate, from personal knowledge, as a person worthy of consideration for registration as an Engineering
Technician with the Engineering Council [and Associate Membership of IPEM]1. We endorse the accuracy of those parts of the application we have
verified by our initials, reference sets of which are given with our signatures.
Proposer 1
Proposer 2
Name:
Name:
Work Address:
Work Address:
Professional Qualifications:
Professional Qualifications:
(Signature of Proposer 1)
Date:
(Initials)
(Signature of Proposer 2)
(Initials)
Date:
Additional supporters should be given where Proposers 1 and 2 alone cannot verify all the information given in this application.
Details of additional supporters, in the form above, should be given on a separate sheet. Supporters, who are not Members of IPEM, should be
Chartered Engineers, Incorporated Engineers or Engineering Technicians and indicate of which Professional Institutes they are members.
Application Checklist: Tick the documents enclosed with this application.
Application Form
Section 2: Competence Statements
FOR OFFICE USE
Authenticated Certificates
Section 3: Supporting Information
Current Curriculum Vitae
Section 4: Organisation Chart
Date received:
Acknowledged:
Reference No:
Qualifications:
Decision:
Notification
Please send your completed form to:
EngTech Registration, IPEM, Fairmount House, 230 Tadcaster Road, YORK, YO24 1ES
1
Delete the words in square brackets if the applicant is already an Associate or Member of IPEM.
Document 0207 v03.00 issue 03-09-2014
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