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#19-004588-0007
Supplemental Questionnaire

Last Name
First Name

 

***Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit.***


1.

Do you have a PE license?

Yes No
2.

Do you have five years of experience designing and reviewing mechanical systems including experience detailing with emergency failures and troubleshooting systemic design? If yes, please describe this experience and include the name of employer(s), date(s) of employment, and job duties related to this experience. If you do not have this experience, please enter N/A.


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