The Institution of Engineers ( India)

Transcription

1 1.0 QUALIFICATIONS: The Institution of Engineers ( India) 8 GOKHALE ROAD, KOLKATA IMPORTANT INFORMATION AND INSTRUCTIONS For FIE Applicants 1.1 Age : Minimum 40 years on the date of application. 1.2 (a) He/she shall either be a Member or shall have fulfilled the conditions necessary for Member; and he/she shall have had at least fifteen years employment in the aggregate in a position of high responsibility in the design or execution of important engineering works. (b) For the purpose of this Bye-Law, employment as a senior member of the engineering staff in an engineering college or institute which has regular courses of study leading to an educational qualification recognised by the Council as exempting from Sections A and B of the Institution Examinations or employment in a high responsible position on important engineering research may be accepted by the Council in place of employment in the design or execution of important engineering works. Visit our website to see the Bye Laws. He/she shall occupy a position of eminence in the engineering field to the satisfaction of the Council. 2.0 FEE PAYABLE ALONG WITH APPLICATION: Sl Application Fee for applicants from Fee for applicants Fee for applicants from No. India & Nepal (`) from SAARC any other countries countries (US $) (US $) 2.1 For Direct Enrolment (paying in single remittance) = = = For Transfer (those who paid AIE to FIE = = =445 composite subscription in AMIE to FIE = = =385 existing grade) MIE to FIE = = = For Transfer (those who paid AMIE to FIE = = =450 Life Compounding Subscription MIE to FIE = = =390 in existing grade) 2.4 For each Journal (Optional) 250 (for 1 year) 25 (for 1 year) 1000 (for 5 years) 100 (for 5 years) N.B. (i) In case of member elected AMIE / MIE after April 1, 1989, the total composite subscription in the existing grade must be cleared before transferring to a higher class of membership. (ii) The breakup as shown in the table above are in the following order: Regn Fee+Entrance Fee+Composite Subscription (in single remittance)+fee for Photo Identity Card [for direct enrolment] or Regn Fee+Transfer Fee+Difference in Composite/Life Compounding Subscription+Fee for Photo Identity Card [for transfer cases]. (iii) Modes of payment are: By Cash at 8 Gokhale Road, Kolkata on any working day between hrs and hrs, or By Demand Draft drawn in favour of THE INSTITUTION OF ENGINEERS (INDIA), payable at KOLKATA, or By Credit Card authorisation as per proforma enclosed, or By Online Payment through our Website : www ieindia.org, or By At Par outstation cheques. 3.0 DOCUMENTS (ATTESTED PHOTOCOPIES) TO BE ATTACHED: 3.1 Certificate in support of date of birth. 3.2 Certificate in support of examinations passed including BE/B.TECH final pass certificate (or marksheets with Provisional Certificates). 3.3 Documentary proof in support of present position/designation. 3.4 In case the applicant is working in a private degree/diploma Engineering College, the Letter of Approval (LOA) of the Institute from AICTE. 3.5 For Self Employed Persons, following additional documents (duly certified by a Chartered Accountant) should be attached: i) Company profile, ii) Age of the organisation, iii) Annual Turnover of the organisation (last 3 years), iv) Number of technical personnel engaged in the organization with details of hierarchy and the position of the applicant therein, v) Important jobs/projects executed during last five years and the involvement of the applicant therein, vi) Contribution to the society through the product or service of the company, and vii) Administrative/Management experience and/or professional attainments, if any. NOTE: ALL OF THESE DOCUMENTS MUST BE ATTESTED BY ONE OF THE SUPPORTERS OF THE APPLICATION. EACH INFORMATION PROVIDED BY THE APPLICANT IN THE APPLICATION FORM MUST BE COUNTERSIGNED BY AT LEAST ONE SUPPORTER. 1 of 9 F

2 4.0 ACKNOWLEDGEMENT: Acknowledgement is sent by SMS regarding receipt of money within seven working days after receiving the documents. Please quote mobile number to get SMS acknowledgement of receipt of money as well as other important announcements. The SMS message containing the reference no. should be noted for any future communication. 5.0 QUERY FOR THE STATUS OF APPLICATION: Through Internet: The processing of application for enrolment normally takes two months time after receipt of the application. The list of New Enrolment and the list of Discrepancies in Applications are available at our website. To know the status of application (after allowing the usual processing period) visit: and click on the Membership tab on the homepage. In case of further query/clarification, applicants may feel free to contact the Membership Department in the Headquarters through the id: Please quote your mobile number and DD no. of remittance in all such communication. Through IVRS: Applicants may also get their queries answered through our Interactive Voice Response System (IVRS). To know the status of application (after allowing the usual processing period), applicants should dial (033) in telephone and follow the instructions as sounded by the system. 6.0 OTHER INFORMATION: (1) Surname and remaining name together should not be more than 37 characters. Leave one box blank after each completed word in filling up names and address in the application form on page 7 of 9. Pin code no. must be mentioned by the applicant correctly for attachment of Centre. (2) Write clearly within the box without touching the boundaries. (3) The form should be properly supported by specified number of member (F/M/AM) as required. (4) Every applicant should carefully note the unique Reference No. received by SMS and DD No.(if paid by Demand Draft) and refer the same for all future correspondence with IEI. (5) Any change in address should be intimated to this office without delay by any of the following means: i) By sending to : pro@ieindia.org, or ii) By sending Letter addressed to the Superintendent, Members Service Cell, The Institution of Engineers (India), 8 Gokhale Road, Kolkata However, change of address can be done by the members themselves by visiting his/her profile in our website: On clicking Log In tab, a member has to register for password etc. If unable to do so, an should be sent to edp@ieindia.org requesting for password by giving mobile no. and id. (6) Any deficiency/ discrepancy in the application form is intimated by sending a letter. Also, month wise list of such Discrepancy in Application with details are available in our website. (7) Only corporate members are eligible for Chartered Engineer certificate (8) Choice of Division part of Journal is optional and a member can opt for two Division part of Journal at the most with fee (see serial no. 2.4 on page 1 of 9). (9) Choice of Division part of the Engineering Journal(s) should be clearly specified along with fee (see page 6 of 9). (10) Signature of the Applicant on the application form, if in any language other than English, must be attested by a Gazetted Officer with seal. (11) For details of membership, please see the Bye Laws and Regulations as available in our website. (12) Applicant residing/practising/working in abroad must remit the fee in US $ only. (13) Complete Application Form along with all necessary documents duly signed by existing Corporate Member (F/M/AM) must be sent by the applicant directly to the Headquarters of the Institution at 8 Gokhale Road, Kolkata and NOT through any agency. (14) In case a candidate is not eligible for election, he/she is eligible for refund of his/her Entrance Fee and the amount deposited for Composite Subscription, without any interest thereon, after deducting non-refundable Registration fee and general office charges as per Regulation. (15) Applicants are advised to keep the photocopies of the filled in Application Form along with the demand draft and all documents attached therewith for information and future reference. (16) Attested copy of documentary evidence (e.g. Marriage Certificate or Affidavit from First Class Magistrate) must be enclosed in support of change in name (if any). (17) No request for change in name is entertained after election. (18) Final decision on every application rests with the Council of IEI only. The decision is final and binding on the applicant. 2 of 9

3 3 of 9 CHECK-LIST OF DOCUMENTS FOR CORPORATE MEMBER F (To be returned along with the application form) Tick out the boxes to check, whether you have filled in/attached the following particulars along with your application : 1. Two photographs affixed on the designated places on page 5 of Demand Draft of Rs. in favour of THE INSTITUTION OF ENGINEERS (INDIA), payable at KOLKATA, if paid by Demand Draft. 3. Credit card authorisation form if paid by Credit Card. 4. Attested Xerox copy of B.E./B.Tech and M.E./M.Tech (if any) and Ph.D (if any) Degree certificates issued by the University duly attested by a supporter of the application. 5. Attested xerox copy of final pass certificate. In case of Provisional certificates, attested xerox copy of Final pass mark-sheet indicating all subjects clearly. 6. Attested xerox copy of documentary evidence in support of date of birth. 7. Attested copy of post qualification professional experience details in chronological order. 8. Experience/career details are duly authenticated by one of the supporters. 9. Attested copy of documentary proof in support of present position/designation. 10. In case the applicant is working in a private degree/diploma Engineering College, the attested xerox copy of Letter of Approval (LOA) of the Institute from AICTE. 11. In case of superannuated persons, attested copy of documentary proof in support of the last position held along with the date of holding the said post. 12. For Self Employed Persons (i) (ii) (iii) (iv) (v) (vi) (vii) Acknowledgement-cum-Receipt (for Office use only) Application Registration No... Received with thanks a sum of Rs.... (Rupees......) from the above named applicant. for Secretary & Director General NOTE : In case a candidate is not eligible for election as member, he/she is eligible for refund of his/her Entrance fee and the amount deposited for composite subscription, without any interest thereon, after deducting non-refundable Registration fee and general office charges as per Regulation. Company profile Age of the organisation Annual Turnover of the organisation (last 3 years) Number of technical personnel engaged in the organization with details of hierarchy and the position of the applicant therein Important jobs/projects executed during last five years and the involvement of the applicant therein Contribution to the society through the product or service of the company Administrative/Management experience and/or professional attainments, if any. This check-list will ensure faster processing and disposal of your application. Name and Address to be filled in by the applicant { The Institution of Engineers (India) 8, Gokhale Road, Kolkata Name... (in Capitals) Full Address Pin Code

4 For any clarification please contact any one of the following addresses State Centres Andaman & Nicobar : PB No. 161, AHW-CSWD Store Complex, Port Blair iei.pblc@gmail.com Andhra Pradesh : Visvesvaraya Bhavan, Khairatabad, Hyderabad Ph : (040) , ieiapsc@gmail.com Assam : Panbazar Overbridge, East Lane, Guwahati , Ph : (0361) , iei_guw@sify.com Bihar : 1942 Kranti Marg (Hardinge Road), Near R-Block Chauraha, Patna Ph : (0612) , ieibsc@gmail.com Chhattisgarh : NIT Campus, Raipur , Ph : (0771) , ieicgsc@gmail.com Delhi : Engineers Bhawan, Bahadur Shah Zafar Marg, New Delhi , Ph : (011) / ieidsc@vsnl.com Goa : D Type Quarters D-8-1, Government Polytechnic Campus, Altinho, Panaji, Goa Ph : (0832) , ieigoa@sify.com Gujarat : Bhaikaka Bhavan, Law College Road, Ahmedabad , Ph : (079) iei_gsc@yahoo.com Haryana : H No. 9, Ranjeet Enclave, Ashoka Nursery, Kunjpura Road, Karnal Ph : (0184) , ieihry@yahoo.com Himachal Pradesh : Victoria Place, Nigam Vihar, Shimla Telefax : (0177) , ieishimla@yahoo.co.in Jammu & Kashmir : Near Amarsingh Club, Sonwarbagh, Srinagar Telefax : (0194) , iei.jksc@rediffmail.com Jharkhand : Engineer Bhavan, Nepal Kothi Campus, Ranchi Ph : (0651) / , ieiranchi@yahoo.co.in Karnataka : 3, Dr B R Ambedkar Veedhi, Bangalore Ph : (080) / , ieiksc@dataone.in, ieiksc@gmail.com Kerala : Visvesvaraya Bhavan, Opp. to Kanakakunnu Palace, Thiruvananthapuram Ph : (0471) , ietvm@vsnl.com Madhya Pradesh : Dr M Visvesvaraya Marg, P.O. Habibganj, Bhopal Ph : (0755) , ieimpsc@yahoo.co.in Maharashtra : 15 Haji Ali Park, Keshavarao Khadye Marg, Mahalaxmi, Mumbai Ph : (022) / , ieimsc@gmail.com Manipur : Govt. Polytechnic Building, 1st Floor, Takyelpat, Imphal , ieimsci@gmail.com Meghalaya : Barik Point, Lachumiere, Shillong (Meghalaya) Ph : (0364) , ieislcm@yahoo.com Orissa : Sachivalaya Marg, Unit IV, Bhubaneswar Telefax : (0674) , ieioscbb@sify.com Puducherry : 63, N S C Bose Salai, PWD Campus, 3rd Floor, Circle-I Office, Puducherry Punjab and Chandigarh : Sector 19A, Madhya Marg, Chandigarh Ph : (0172) , ieichd@yahoo.com Rajasthan : Gandhi Nagar, Tonk Road, Jaipur Ph : (0141) / , rsc@ieirsc.org Tamilnadu : 19 Swami Sivananda Salai, Chepauk, Chennai Ph : (044) / , ieitn@vsnl.com Tripura : Pandit Nehru Complex, Near Tripura Housing Board, P.O. Kunjaban, P. B. No. 139 Agartala , Tripura, Telefax : (0381) , iei_agt@engineer.com Uttarakhand : Saharanpur Road, Opposite ISBT, Mazra, Dehradun Ph : (0135) , iei_uasc@rediffmail.com Uttar Pradesh : Engineers Bhawan, River Bank Colony, Lucknow Ph : (0522) , ieiupsclko@rediffmail.com West Bengal : 8 Gokhale Road, Kolkata , Ph : (033) , iei.wbsc@gmail.com Local Centres Ahmednagar : Irrigation Compound, Aurangabad Road, Ahmednagar Ph : (0241) , ieialc@rediffmail.com Aligarh : Z H College of Engineering & Technology, Aligarh Muslim University, Aligarh (UP) iei_aglc93@yahoo.com Allahabad : Teliarganj, Allahabad , Ph : (0532) / , ieicha_ald@yahoo.co.in Alwar : Govt. Polytechnic College Campus, Kali Mori, Alwar , ieialwar@gmail.com Amravati : Triveni House, 10/43, Rukhmini Nagar, Amravati (Maharashtra) ieiamtms@rediffmail.com Angul : NALCO Smelter & Power, Training Institute, NALCO Nagar, P.B. No. 30, Angul (Orissa) Telefax : (06764) Anpara : 2-Room Field Hostel, ATPS, PO : Anpara, Sonebhadra (UP) Telefax : (05446) , iei_anpara@rediffmail.com Asansol : L W Office Campus, Indian Iron & Steel Co. Ltd, Burnpur Road, Burnpur Dist. Burdwan (WB), Ph : (0341) , ieiasnlc@gmail.com Aurangabad : Railway Station Road, Osmanpura, Aurangabad Ph : (0240) , ieialc@yahoo.co.in Barauni : Auditorium Complex, Barauni Thermal Power Station, Begusarai (Bihar) Ph : (06243) Bathinda : Kartar Colony, Behind Deaf & Dumb, School, Goniana Road, Bathinda (Punjab) Ph : (0164) , ieibti@rediffmail.com Belapur : Plot No. 106, Sector 15, CBD, Belapur, Navi Mumbai Ph : (022) , ieibelapur@gmail.com Belgaum : Double Road, Shivabasavanagar, Belgaum (Karnataka) Ph : (0831) , ieibgm@gmail.com Berhampur : Room No. 225, U.C.P. Engineering School, Berhampur (Orissa) ieiblc_india@yahoo.in Bhilai : Indira Place, Civic Centre, Bhilai , Ph : (0788) , ieiblc@yahoo.com Bokaro Steel City : Abhiyanta Bhavan, Sector 5-A, Bokaro Steel City Ph : (06542) /288972, ieibsclc@yahoo.co.in Calicut : Anand Buildings, Second Floor, Pavamani Road, Calicut , iei_calicut@rediffmail.com Chandrapur : Campus of Rajiv Gandhi College of Engg. & Technology, Ballarpur Road Chandrapur , Ph : (07172) Extn 201/236, ieilc.chandrapur@gmail.com Coimbatore : PSG College of Technology Campus Peelamedu, Coimbatore Ph : (0422) , ieiclc@yahoo.co.in Davangere : Post Box No. 319, M.C.C. B Block, Davangere Dhanbad : Veena Engineers Building, Golf Ground, Dhanbad Ph : (0326) , iei_dlc_10@yahoo.co.in Dharwad : Balekundry Bhavan, Sir M Visvesvaraya Road, Dharwad (Karnataka) Ph : (0836) , ieidlc@sancharnet.in Durgapur : Nehru Avenue, B Zone, Durgapur Telefax : (0343) , dgp_ieidgp@yahoo.in Faridabad : YMCA Institute of Engineering, Quarter No. 45, Sector 6, Faridabad Ph : (0129) , ieifbdlc@hotmail.com Ghaziabad : 15 Shopping Complex, ALTT Centre, Raj Nagar, Ghaziabad (UP) Ph : (0120) , iei_glc@yahoo.com Gulbarga : Visvesvaraya Bhavan, Court Road, Gulbarga Ph : (08472) , iei_gul@yahoo.com Indore : SGSITS Campus, 23 Visvesvaraya Marg (Park Road), Indore Ph : (0731) , ieindore@yahoo.co.in Jabalpur : Visvesvaraya Marg, Civil Lines, Jabalpur Telefax : (0761) , jlc_iei@yahoo.co.in Jammu : Institution Complex, Sector 3, Channi Himmat, Jammu Ph : (0191) , ieijammu@rediffmail.com Jamshedpur : Subarnarekha Link, Sakchi, Jamshedpur (Jharkhand) Ph : (0657) , ieijlc@rediffmail.com Jodhpur : Residency Road, Jodhpur , Ph : (0291) , ieijlc@gmail.com Kadapa : Prakash Nagar, Kadapa , Telefax : (08562) , ieikadapa@rediffmail.com Kakinada : JNTU College of Engg. Campus, NFCL Road, Kakinada Kalpakkam : 4th Avenue, DAE Township, Kalpakkam Telefax : (044) , ieiklc@igcar.gov.in Kanpur : Engineers Bhawan, HBTI East Campus, Nawabganj, Kanpur Telefax : (0512) , ieikanpur@hotmail.com Kharagpur : Indian Institute of Technology Campus, Kharagpur (WB) Ph : (03222) to 224 / to 393 Extn 8047, ieiklc2008@gmail.com Kochi : St Benedict Road, Kochi , Ph : (0484) , ieikochi@vsnl.com Kolhapur : C/o Executive Engineer, Minor Irrigation Division, Sinchan Bhawan, Tarabai Park Kolhapur , Ph : (0231) , ieikolhapur@gmail.com Kollam : TKM College of Engineering, TKM College P O, Kollam (Kerala) Kota : Engineers Bhawan, Near ESI Hospital, Jhalawar Road, Kota Ph : (0744) , ieiklc@yahoo.com Ludhiana : Institution Building, Dugri Road, Ludhiana , ieindia.llc@gmail.com Madurai : T M Jambulingam Bhawan, 1, Vivekanandha Nagar, Surveyor Colony, 100 Feet Road K Pudur, Madurai , Ph : (0452) , iei_mlc@yahoo.com Mangalore : Second Floor, Opal Complex, Opp. Bejai Chuch, Bejai, Mangalore Ph : (0824) , ieimangalore@yahoo.co.in Munirabad : Sir M Visvesvaraya Centenary Hall, Munirabad Muzaffarpur : Muzaffarpur Institute of Technology, Muzaffarpur (Bihar), Ph : (0621) Mysore : Jhansi Lakshmibai Road, Mysore Ph : (0821) / , ieimysore@sancharnet.in Nagpur : North Ambazari Road, Nagpur Ph : (0712) / , ieingp_ngp@sancharnet.in Nashik : PWD Campus, Bharat Ratna, Sir Visvesvaraya Marg, Nashik Ph : ( 0253) , ieinsk@gmail.com Neyveli : Institution Building, Block 17, Neyveli Ph : (04142) , ieineyveli@rediffmail.com North Bengal : Jalpaiguri Govt. Engg. College, Jalpaiguri Ph : (03561) , sec_nblc@hotmail.com Palghat : Nerukakkad, Kalleppully, PO : Palakkad Ph : (0491) , ieipalghatindia@rediffmail.com Pantnagar : 209A (Old Building), College of Technology, Pantnagar (UP) Ph : (05944) /233457, iei.plc@gbpuat-tech.ac.in Pune : 1332, Shivajinagar, J M Road, Pune Ph : (020) / , plc.iei@gmail.com Ranipet : C-399 BHEL Township, Ranipet , Vellore Dist, Tamilnadu Roorkee : IIT Campus, Roorkee , Ph : (01332) , hsieirlc@yahoo.in Rourkela : NIT Campus, Rourkela , Telefax : (0661) , rkl_ieirlc@sancharnet.in Salem : 20A, A Block, 2 nd Floor, Green Park Avenue, Opp Hotel Ganesh Mahal, Omalur Main Road (Near New Bus Stand), Salem , Ph : (0427) , ieisalemlocal@gmail.com Saurashtra : 312 Madhav Complex, Dr Yagnik Road, Rajkot , Ph : (0281) Silchar : Trunk Road, Silchar , Ph : (03842) , ieislc@yahoo.co.in Solapur : IV Floor, 3 North Kasaba, Near Laxmi Bank, Shivaji Chowk Solapur , ieisolapur@gmail.com South Gujarat : Mahida Bhavan, Ichchanath, Surat , Ph : (0261) , ieisurat@yahoo.com Sunabeda : Post Box No. 11, Sunabeda , ieisunabeda@gmail.com Tiruchirapalli : BHEL Main Office Road, Tiruchirapalli , Ph : (0431) ieitlc@sancharnet.in Tirupati : S V U College of Engineering Campus, Tirupati , Ph : (0877) Trichur : TMC 36/5837, Vrindavan, Shornur Road, Trichur , Ph : (0487) , ieitcr@yahoo.com Tuticorin : 8/4 Jeyaraj Road, Meenakshipuram West, Tuticorin Ph : (0461) , ieituty@yahoo.co.in Udaipur : 128 Hiran Magri, Sector 11, Opp. Central Excise, Udaipur Ph : (0294) , insti_of_eng@yahoo.co.in Upper Assam : P.O. Parbatpur , Dist. Dibrugarh (Assam) Ph : (0374) , bvfclnam@sancharnet.in Vadodara : Race Course Circle, Opp. GERI, Vadodara Ph : (0265) / , iei.vadodara@gmail.com Vallabh Vidyanagar : C/o B V Mahavidyalaya (Engineering College), P B No. 20, Vallabh Vidyanagar Dist. Anand (Gujarat), Ph : (02692) , Varanasi : 2nd Floor (Above Room G-14), Institute of Technology, Benaras Hindu University Varanasi (UP), Ph : (0542) , iei_vlc@yahoo.co.in Vijayawada : Dr K L Rao Bhavan, Governorpet, Vijayawada , Telefax : (0866) , ieivjlc@yahoo.co.in Visakhapatnam : Visvesvaraya Bhavan, Station Road, Dondaparthy, Visakhapatnam (AP) Telefax : (0891) , ieivisakha@rediffmail.com Warangal : D-7/2 Nit Quarters, Warangal LOCATION OF OVERSEAS CHAPTERS Abu Dhabi : PO Box No. 3967, Abu Dhabi, UAE, Ph : ( ) , Fax : ( ) Kuwait : PO Box No. 9554, Salmiya 22096, Kuwait, Ph : (00965) / , Extn : 314 Bahrain : PO Box No. 1724, Manama, Bahrain, Fax : (00973) , ieibc@yahoo.com Telefax: (00965) , ieikwt@hotmail.com Dubai : PO Box No. 2314, Dubai, UAE, Ph : ( ) , Fax : ( ) Qatar : PO Box 18523, Doha, Qatar, Telefax: (00974) ieiqatar@gmail.com 4 of 9

5 The Institution of Engineers ( India) 8 GOKHALE ROAD, KOLKATA Application for Fellowship (FIE) 5 of 9 F Name : (in Capitals) [Surname] [Remaining Name] Specimen Signature of the applicant (preferably in English) Signature * Attested The signature should not touch the box (Use black ink only) * In case of regional language, signature attestation is a must by a Gazetted Officer with Seal Supporter : Verified the photograph and signature of the applicant Passport or stamp size photograph to be pasted here (do not sign on the photograph) Name (in Capitals) Membership No. Signature (in English only) with date 1... F/M/AM Note : The Photograph and signature are to be verified by one of the supporters who will sign on page 7 of 9 of the membership application form. For Office Use Meeting No. Date Approved for Enrolled on Division attached Journal Choice Excess amount, if any, received for Chartered Engineer Certificate : Rs. Journal Any other : Rs. : Rs. Director (Membership) Encl : (A) Draft no. for Rs. Date Bank name & branch (in Capitals) (B) Credit Card No. (if paid through Credit Card authorisation) (C) Request Reference No. (if paid online) Note : Please use DD No./Credit Card No./On line reference No. for queries, if any. For Office Use For Office Use Name : (in Capitals) [Surname] [Remaining Name] Specimen Signature of the applicant (preferably in English) The signature should not touch the box (Use black ink only) Passport or stamp size photograph to be pasted here (do not sign on the photograph)

6 6 of 9 Note 1 *Note 2 : The applicant shall be attached to the Division as per his/her engineering qualification. Choice of attachment to any other Division needs to be supported by adequate proof of expertise/experience in that Division. : The applicant of Group of Engineering / Technology shall be attached to the respective Engineering Division as per table given below. For Instrumentation & Measurement, Instrumentation Group, option may be exercised and indicated. Group of Engineering / Technology Petroleum, Petrochemical, Biotechnology, Food Technology, Biochemical Engineering, Pulp and Paper Technology, Sugar Technology, Leather Technology, Plastics & Rubber Technology, Polymer Engineering, Polymer Science & Rubber Technology, Oil Technology, Paint Technology Ceramic Engineering / Technology, Material Science & Technology Information Technology Instrumentation & Measurement, Instrumentation, Bio-medical Engineering, Applied Electronics & Instrumentation Engineering Industrial Engineering, Automation & Robotics Engineering, Industrial Engineering and Management, Printing Technology Power Engineering, Electrical & Electronics Engineering, Instrumentation & Control Engineering Automobile Engineering, Energy Transportation Engineering Chemical Engineering Engineering Division Metallurgy & Materials Science Computer Engineering Electronics & Telecommunication Engineering/ Electrical Engineering Electronics & Telecommunication Engineering Production Engineering Electrical Engineering Mechanical Engineering Civil Engineering * Please indicate choice of attachment to Division where applicable, Please see Note 2 above. (indicate one Division only with a tick mark inside the box). Aerospace Computer Mechanical Agricultural Electrical Metallurgy & Materials Science Architectural Electronics and Telecommunication Mining Chemical Environmental Production Civil Marine Textile Please tick in the box if you wish to receive on payment ONE or TWO Division part(s) of the journal Aerospace Computer Mechanical Agricultural Electrical Metallurgy & Materials Science Architectural Electronics and Telecommunication Mining Chemical Environmental Production Civil Marine Textile Interdisciplinary I wish to have the journal in softcopy/ hardcopy (please tick the appropriate box).

7 The Institution of Engineers ( India) 8 GOKHALE ROAD, KOLKATA Tel No. (91)(033) /14/15/16/33/34, Fax No. (91)(033) , membership@ieindia.org Use All Capital Letters within the box without touching the boundaries. Leave one box blank after each completed word * Surname * Remaining Name * As per B E Degree Certificate and Surname & Remaining Name together should not be more than 37 characters Father s/ Husband s Name 7 of 9 F A D D R E S S PIN State Country Tel (O) Tel (R) Mobile d d m m y y y y Date of birth Age as on Date : Year Months Nationality Existing Grade of Membership No. (M/AM/G) : The Secretary & Director General The Institution of Engineers (India) Date... 8 Gokhale Road, Kolkata Dear Sir, 1. I hereby apply for election as a Fellow of the Institution of Engineers (India) in accordance with the Charter of Incorporation and the Bye- Laws as they now stand or as they may be legally altered hereafter. 2. I do hereby undertake that in the event of my election as a Fellow, I will be governed by the Bye-Laws and the Regulations of the Institution as they now are or as they may hereafter be legally altered and that I will accept as final and binding the decisions of the Council in all matters dealt with by them in accordance with the provisions of the Charter, Bye-Laws and Regulations, and will forthwith cease to describe myself as a Fellow or to designate myself as belonging to the Institution in any other form, on receipt of a notice from the Secretary and Director General that acting under the powers conferred upon them by the Bye-Laws and Regulations the Council have declared me to be no longer as a Fellow of the Institution. I further undertake that I will promote the objects of the Institution, as far as may be in my power, provided that whenever I shall signify in writing to the Secretary and Director General that I am desirous of withdrawing from the Institution, I shall after the payment of any arrears which may be due by me at that period be free from this obligation. 3. I have noted that the decision of the Council of the Institution shall be final in granting the Membership and the District Courts at Alipore, 24 Parganas (South) shall have the exclusive jurisdiction in settling the dispute, if any, arising out of this Membership. 4. I accept responsibility for the accuracy of the particulars contained in the application form with regard to my qualification and experience and agree that if I am elected the validity of my election shall depend upon the accuracy of such particulars as required in the Bye-Laws. I also undertake to abide by professional conduct rules and/or Code of Ethics that the Council may frame from time to time. Yours faithfully Enci. Copies of... documents.... Signature of the applicant (*in English only)... Regn. No. Signature *Attested * In case of regional language, signature Do not write anything within the box attestation is a must by a Gazetted Officer with Seal (for office use only) SUPPORTERS : From personal knowledge of the applicant and in consideration of his/her qualifications as stated on the reverse, I recommend him/ her to the Council as being in every way a fit and proper person to be admitted to the Institution as a Fellow. Name (in Capitals) Membership No. Signature (in English only) with date 1... F F F......

8 Note : Each information provided by the applicant must be authenticated by a supporter of the application ENGINEERING Name of Examination/s Branch of Examining Full Name and Address of the Year of Passed or Section Engineering Authority College/Institution IE(I) Passing B of lei Roll No of 9 Authentication by a Supporter Present Position Exact Designation Place of Posting Full name and address of the present employer Authentication by a Supporter Uptodate Chronological Engineering Career Designation(s) Name and address of Employer From (Date) To (Date) of post(s) held Authentication by a Supporter In the case of Self-employment / Consultancy, please enclose i) Company profile, ii) Age of the organisation, iii) Annual Turnover of the organisation (last 3 years), iv) Number of technical personnel engaged in the organization with details of hierarchy and the position of the applicant therein, v) Important jobs/projects executed during last five years and the involvement of the applicant therein, vi) Contribution to the society through the product or service of the company, and vii) Administrative/Management experience and/or professional attainments, if any (all documents duly attested by a supporter). For Military Personnel only (i) Present Rank, (ii) Actual date of Commission, and (iii) Personal Number Details of Professional Career : (a) Most Important Engineering works for which personally responsible (Please attach statement duly attested) (b) Research and Teaching Experience (if any) [Please attach statement duly attested] (c) Specialisation (if any) [Please attach sheet duly attested] Technical Papers Published (if any) [Please attach sheet duly attested as per following format] Title of the Paper Name of Journal Date of Publication in which Published Membership of other Engineering Institutions/Societies (if any) [Please attach sheet duly attested as per following format] Name of Institution / Society Grade of Date of Whether still Membership Election a Member

9 9 of 9 Please fill-up the form in duplicate ORIGINAL AUTHORISATION AUTHORISATION OF PAYMENT BY CREDIT CARD Credit Card MASTERS VISA OTHERS Please charge Rs.... against Card No. Amount in Word... Card Expiry Date M M Y Y Y Y Card Holder s Signature... Card Holder s Name... Applicant s Name... Membership Grade &... No. [If applicable] DUPLICATE AUTHORISATION AUTHORISATION OF PAYMENT BY CREDIT CARD Credit Card MASTERS VISA OTHERS Please charge Rs.... against Card No. Amount in Word... Card Expiry Date M M Y Y Y Y Card Holder s Signature... Card Holder s Name... Applicant s Name... Membership Grade &... No. [If applicable]