Form Pes 4012 2011 PDF Details

Ensuring professional growth and adherence to state regulations, professionals in the realms of engineering and surveying in Ohio are familiar with the crucial role that the PES 4012 form plays in their career. This document serves as the backbone for the Continuing Professional Development (CPD) Activity Log, a mandatory requirement set forth by Ohio's State Board of Registration for Professional Engineers and Surveyors. It demands a meticulous logging of all CPD activities closely aligned with the practice of engineering or surveying, covering areas from technical insights to ethical considerations and managerial prowess. Designed for the comprehensive tracking of CPD hours crucial for the annual renewal of Ohio P.E. and P.S. registration, this form emphasizes the necessity of not just accruing but also documenting professional growth accurately—fifteen CPD hours are the minimum yearly requirement, with the flexibility of carrying over a maximum of another fifteen CPD hours to the next year. Beyond its function as a tracker, this document underscores its importance by reminding professionals that it doesn't replace the tangible evidence of certificates or other documentation as per the Ohio Revised Code section 4733.151. Through its stringent yet necessary requirements, the PES 4012 form exemplifies the balance between continuous learning and regulatory compliance, ensuring that professionals remain at the forefront of their disciplines.

QuestionAnswer
Form NameForm Pes 4012 2011
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other names4012 2011 20120103 Nitro ohio peps form

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OHIO’S STATE BOARD OF REGISTRATION FOR PROFESSIONAL ENGINEERS AND SURVEYORS

 

Continuing professional development (CPD) activity log

4012-2011

All CPD activities and courses must be relevant to the practice of engineering or surveying and include technical, ethical or managerial content.

This form is required for tracking your CPD hours for Ohio P.E. and P.S. registration annual renewal. This form does not replace copies of your certiicates of completion or other documentation required by Ohio Revised Code section 4733.151. Fifteen CPD hours are required for Ohio registration renewal. A maximum carryover of 15 CPD hours are allowed per year. For information about the Board’s CPD requirements, go to our website at www.peps.ohio.gov/ContinuingEducation.aspx.

YOUR OHIO P.E., P.S. REGISTERED NAME AS IT IS ON YOUR LICENSE

 

 

P.E. NUMBER

 

P.S. NUMBER

 

FOR CALENDAR YEAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

0

 

1

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

SPONSOR /

LOCATiON:

ACTiviTy TiTLE,

 

 

 

 

 

 

 

CPD hRS

[mm/DD]

PROviDER

ADDRESS, CiTy, STATE, ZiP

 

DESCRiPTiON

 

iNSTRuCTOR

 

 

 

EARNED

FROM

TO

FROM

TO

FROM

TO

FROM

TO

FROM

TO

2010 CPD

TOTAL

TOTAL

The CPD credits listed herein are true and correct, and accurately state the professional development hours I have earned.

CARRIED OVER

2011 CPD

CPD

 

 

 

(MAXIMUM 15)

EARNED

EARNED

SIGNATURE

DATE SIGNED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State Board of Registration for Professional Engineers and Surveyors

50 West Broad Street, Suite 1820

Columbus, Ohio 43215-5905

877 | 644 6364 U.S. toll free

614 | 466 3651 Columbus metro

614 | 728 3059 Fax

WEB www.peps.ohio.gov

PES 4012-2011 (Rev. 12/2011) 20111220

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