Get Weblic&examverform.doc

Filling out the WebLic&ExamVerForm.doc online is a straightforward process. This guide will provide you with clear instructions to ensure that you accurately complete each section of the form.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and open it in your online editor.
2. Complete the shaded areas designated for the applicant. This includes entering your full name, address, and date of birth. Be sure to provide your Social Security number, using only the last four digits.
3. Indicate your licensure status by checking the appropriate boxes for Engineer Intern, Professional Engineer, Surveyor Intern, or Professional Surveyor. Fill in your license number, the date it was issued, and its validity period.
4. Provide the examination details by listing the exam taken, the examination hours, the results, and the exam date. Include the appropriate information from the NCEES and note the cut-score used.
5. Respond to the disciplinary action question by selecting 'Yes' or 'No.' If you answer 'Yes,' attach documentation or provide full details of the board action on the reverse side.
6. Ensure the form is signed by the authorized representative of the State Board and includes the board’s seal, if necessary. Note the date the form is completed.
7. Finally, save your changes, download the completed form, and prepare it for mailing to the Mississippi Board of Licensure for Professional Engineers & Surveyors at the provided address. Don’t forget to include a stamped envelope addressed to the board.

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