Fundamentals of Engineering Re-Examination Application (Printable)
FBPE Office Use Only
Write Name on Back of Picture
Attach passport photo or copy of valid Drivers
Check this box if Conditional
Documents are attached
license to a separate blank page
Fundamentals of Engineering Florida Board of Professional Engineers
Re-Examination Application 2507 Callaway Road, Suite 200
Fee: $30.00 Tallahassee, FL 32303
ATTN: Sean Benjamin (850) 521-0500
1. APPLICANT PROFILE DATA: PLEASE TYPE OR PRINT WITH BALL POINT PEN
Name Last First Middle
Number and Street Apt/Lot No.
Address City County State Zip Code
*Social Security numbers are mandatory pursuant to Title 42 United States Code, Sections 653 and 654; and Sections 455.203(9), 455.213(1)
409.2577, and 409.2598, Florida Statutes: Social Security number:
We are required to ask that you furnish the following information as part of your voluntary compliance with Section 2, Uniform Guidelines on Employee
Selection Procedure (1978) 43FR38296 (August 25, 1978). This information is gathered for statistical and reporting purposes only and does not in any
way affect your candidacy for licensure.
Race: Other: Sex:
Caucasian African-American Hispanic Asian Native American Male Female
Home Telephone No. Home Telephone No. Email Address
Date of Birth Place of Birth (City, State, County)
Have you ever changed your name through marriage or through action of a court, or have you ever been known by any other name:
YES NO if YES, list name(s) and date(s) of change below:
To change the name we currently have on file, a copy of the marriage certificate or court order is required. (please attach)
3. EXAMINATION HISTORY: List the date of the last Engineer Intern Examination you have taken or were scheduled for:
4. SPECIAL TESTING ACCOMMODATIONS:
Please Contact ELSES at www.els-examreg.org.
Check List for Reexamination Applicants
Complete the enclosed application document and return it to the Florida Board of Professional Engineers, 2507 Callaway Rd, Suite 200,
Tallahassee, FL 32303.
Attach to the reexamination application a check or money order for $30.00 made payable to the Florida Board of
Attach a copy of your passport photo or copy of a valid Driver’s license to a separate blank page and attach it to your application. Please sign the
back of photograph in the event it becomes separated from the application.
It is imperative that you advise us and ELSES of any changes of address. Failure to do so may prevent delivery of important information
regarding your application and examination dates. Address changes for ELSES should be sent per ELSES instructions. A copy of the
marriage certificate or court order is required. (Attach it to this Application)
If you have graduated since the last time you have taken the examination, you are required to submit an official transcript showing that your
undergraduate degree has been awarded. This is a requirement to be eligible to retake the exam. Check this box if Conditional Documents are
For those currently enrolled, if your anticipated graduation did not occur, or has changed, then please submit a new letter of good standing to the
Board Office. If your status has not changed (graduation date, major) then you do not need to submit a new form.
If you have any questions, you may contact:
Sean Benjamin Licensure Analyst
Florida Board of Professional Engineers, 2507 Callaway Road, Suite 200
Tallahassee, Florida 32303. Telephone Number: (850) 521-0500.
Email Address: email@example.com
FBPE FEREApp 001 09/07