LAND SURVEYING EXPERIENCE SUMMARY ALL INFORMATION MUST BE TYPED ON NO MORE THAN 3 PAGES. Page

APPLICANT

_

Dates of Work in Chronological Order

List your Title, Company Name and a DETAILED description of your responsibilities for all jobs since completing high school

1. 2. 3. 4. 5. 6.

ACCOUNT FOR ALL GAPS IN EMPLOYMENT (e.g. school, unemployed, traveling, etc.)

Research Measurement/Location Computation/Analysis Legal Principles Management of Surveying Other non-surveying work See Land Surveying Experience Summary Instructions. Enter each column as a percentage of experience for that position.

of _ pages

Supervisor Name, Licensure Status, Title and Company

All five columns must total 100% for each position. Do not overlap dates From To mo/yr mo/yr

NOTE: Failure to submit sufficient detail of your experience may delay the processing of your application.

(1)

(2)

(3)

(4)

(5)

(6)

01/2016

LSI and PLS - Experience Summary Form.pdf

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