APEC Engineer Perú Continuing Professional Development

1. Attendance at congresses, conferences, workshop and seminars. Last five years. In descending order starting with the most recent.

No. Event Organizer Date Duration (Hours) Place  .  .  .

2. Attendance at university courses and specialization courses. Last five years. In descending order starting with the most recent.

No. Course University Date Duration (Hours) Place  .  .  .

3. Publication and presentation of technical papers and opinion papers in journals and other. written media. Last five years. In descending order starting with the most recent.

No. Paper Title Authors Journal Date  .  .  .

4. Presentation of technical papers in congresses, conferences, workshops, seminars. Last five years. In descending order starting with the most recent.

No. Paper Title Authors Event Date  .  .  .

5. Academic degrees.

Master Degree Degree in: University Date Place  .  .  .

Doctor Degree
Degree in:	University	Date	Place
.
.
.

6. Technical and professional certifications. In descending order starting with the most recent.

No.	Certification	Certifier	Date	Validity (Years)
.
.
.

7. Membership in Professional and Technical Societies.

No.	Institution / Society	Status / Level	Period of Membership	Main Activities
.
.
.

I hereby swear that the above descriptions are true.

Date:

Applicant Name:

Signature: