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State of Maryland Department of Labor Maryland Board for Professional Engineers 100 S. Charles St, Tower 1, 3rd Floor Baltimore, Maryland 21201 (410) 230-6322 (Baltimore area), (888) 218-5925 (toll free) |
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RECIPROCITY APPLICANT MUST COMPLETE THE FOLLOWING:
| FULL NAME | |||
| LAST | FIRST | MIDDLE | |
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| Name of College/University | Degree | Graduation Date | |
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| Name of College/University | Degree | Graduation Date | |
| NOTE: | An official academic transcript must be sent to the Board's office directly from the college registrar. Transcripts marked "issued to student" will not be accepted. |
| Engage- ment Number |
Date | Employment Record (a)Name, Complete Location and Character of Business (b)Kind of applicant's Engineering Work (c)Degree of Responsibility |
Engineering Experience Claimed | Name and complete Address of Person Familiar with Each Position | |||
| Mo. | Yr. |
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