Online Address Change Form

Note to EIT/LSIT applicants: Do not use the below Address Change Form if you submitted your application using the New Online BPELSG Connect Portal; you must login to BPELSG Connect to complete an address change. If you submitted your application prior to the launch of the Online Application Portal, use this form to complete an address change.

Note to Licensees: Do not use the below Address Change Form if you have submitted a renewal using the New Online BPELSG Connect Portal; you must login to BPELSG Connect to complete an address change. If you have not submitted a renewal in BPELSG Connect, and you are not submitting a renewal in BPELSG Connect within the next thirty (30) days, use this form to complete an address change.


To change your address of record, please provide the following information and endorse with the last four digits of your Social Security number.

Please allow 2-3 weeks for processing of any address change requests.

Pocket and wall certificates are not re-printed when a change of address is submitted.

You cannot change your name online. Click here to download the Change of Name form.

412. Address Change for Engineers and Land Surveyors.

Each person who is an applicant for, or a holder of, a certificate or license issued by the Board under provisions of the Professional Engineers Act or the Professional Land Surveyors' Act shall file his/her address with the Board office. Within thirty (30) days after changing addresses, he/she shall notify the Board office of such change.

3009. Address Change for Geologists and Geophysicists.

Each person who is an applicant for or a holder of a certificate license issued by the Board shall file his or her address of record with the Board. Within thirty (30) days after any change to his or her address of record, he or she shall notify the Board in writing of such change.

Please complete the following information. Note: Licensees must include the license number. If you do not know your license number, you may click here to obtain it from the Verify a License screen.

Address Change Form
Fields marked with an asterisk (*) are mandatory.
*I am a
*If a Licensee
Additional License (if applicable)
Additional License (if applicable)
If an Applicant:
Personal Information
*Old Mailing Address:
*New Mailing Address:
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