Applicant’s Name (Last) (First) (Middle)
Section 3
Military Service Inquiry/Expedited Licensure Process for Military Spouses, Refugees, Asylees and Special Immigrant Visa Holders
Military Service Inquiry
Business and Professions Code section 114.5 requires the Board to ask all applicants if they are currently serving in, or have previously
served in, the United States military. Answering this question is optional.
Are you currently serving in or have you previously served in the United States military?
YES
NO
Expedited Licensure Process for Military Spouses
Pursuant to Business and Professions Code Section 115.5, the Board shall expedite the licensure process for an applicant who meets
BOTH of the following requirements:
1. Is married to or in a domestic partnership or other legal union with an active duty member of the U.S. Armed Forces who is
assigned to a duty station in California under official active duty military orders; and,
2. Who holds a current license in good standing in another state, district or territory of the United States in the profession for which
the applicant is seeking licensure.
If you meet BOTH of the above-listed requirements and would like to be considered for the expedited review process, you must provide
all of the following documentation:
1. A copy of the marriage certificate or certified declaration/registration of domestic partnership; and,
2. A copy of the spouse’s/domestic partner’s active duty military orders establishing the duty station in California; and,
3. Official certification verifying the applicant holds a current license in good standing in another state, district, or territory of the U.S.
in the same profession in which they are seeking licensure in California.
Do you wish to have your application considered for the expedited review process? YES NO
If YES, include the required documentation with this application.
Expedited Licensure Process for Refugees, Asylees, and Special Immigrant Visa Holders
Business and Professions Code section 135.4 provides that the Board must expedite, and may assist, the initial licensure process
for certain applicants described below.
Do any of the following statements apply to you?
• You were admitted to the United States as a refugee pursuant to section 1157 of title 8 of the United States Code;
• You were granted asylum by the Secretary of Homeland Security or the United States Attorney General pursuant to section 1158
of title 8 of the United States Code; or,
• You have a special immigrant visa and were granted a status pursuant to section 1244 of Public Law 110-181, Public Law 109-163,
or section 602(b) of title VI of division F of Public Law 111-8, relating to Iraqi and Afghan translators/interpreters or those who
worked for or on behalf of the United States government.
YES
NO
If you selected YES, you must attach evidence of your status as a refugee, asylee, or special immigrant visa holder. Failure to do so may
result in application review delays.
Section 4
Discipline
Have you ever had an engineering, land surveying, geologist or geophysicist related license denied, disciplined, suspended,
surrendered, or revoked in any state (other than for lack of minimum qualification or failure of examination)? If YES, provide
an explanation on an additional sheet of paper.
YES NO
NOTICE: Under the laws of the State of California, the State Board of Equalization and the Franchise Tax Board are allowed to share
taxpayer information with the Board for Professional Engineers, Land Surveyors, and Geologists. The laws require a licensee to
pay his or her state tax obligation, and his or her license may be suspended if the state tax obligation is not paid.
Applicant’s Signature (Wet Signature Required) Date:
Page 3 of 3
APPLICATION FOR LICENSURE AS A PROFESSIONAL ENGINEER
(Revised 1/2021)
