FUNDAMENTALS OF ENGINEERING EXAM

APPLICATION FOR UNDERGRADUATE STUDENTS ONLY

If you are unable to use the on-line form, use this form either as an e-mail attachment and send to ksbtp3@ink.org or fill it out, print it and mail it to Kansas State Board of Technical Professions, 900 SW Jackson St., Suite 507, Topeka, KS 66612.

This application is to determine eligibility to sit for the exam. There is no fee payable to the Board. There will be a fee payable to NCEES.  Once your application has been approved by the Board, you will receive a letter with instructions on how to register to sit for the exam with NCEES.

Full Legal Name: ________________________________________________________

University: ___Kansas State University ____University of Kansas ____Wichita State University

Current Mailing Address (Street, Apt #): _____________________________________

City, State & Zip Code:_____________________________________________________

Permanent Mailing Address (Street): _________________________________________

City, State & Zip Code: _____________________________________________________

(Exam results will be mailed to the permanent address after the end of the semester.)

I have achieved at least junior status in an ABET accredited baccalaureate engineering curriculum, as stated in K.A.R. 66-9-4.

I expect to graduate (Month & Year): ______________________________

Last 4 digits of Social Security No. __________

Contact information:

Day Time Phone:___________________ Evening Phone: ____________________

Email Address: (Optional) ____________________

By submitting this application form I certify that the above information is true and correct to the best of my knowledge and belief. I hereby authorize the educational institutions which I have attended to release information concerning my academic standing to the Board for use in considering my application for examination pending before the Board.