The Nigerian Society of Engineers

AFFIX A RECENT PASSPORT SIZE PHOTOGRAPH OF SELF HERE The Nigerian Society of Engineers NATIONAL ENGINEERING CENTRE off National Mosque-Labour House Road, Central Business Area, E-mail: nsehqr@linkserve.com Abuja, Nigeria Website: http://www.nse.org.ng APPLICATION FOR FELLOWSHIP GRADE BY INVITATION Election to the NSE Membership Grade of Fellow by Invitation recognizes an Engineer: who has been a Corporate Member of the Society for at least one year. registered by the Council for the Regulation of Engineering in Nigeria (COREN), for at least one year. should have demonstrated notable engineering excellence and achievements. Who has held responsible engineering position of level of GM in reputable private sector organisation or Director in the public service, or the equivalent. has continuously had professional development A candidate seeking for the Grade of Fellow by Invitation must be a financial member of NSE but may not seek endorsement by a Branch or Division Chairman. However, the candidate should provide sufficient evidence of all claims made in this form. In addition, He/She must provide two financial Fellows of the Society as referees, who must be from his/her Division. There must be consistency in the payment of subscription/dues by the candidate. Candidates must also submit proofs of COREN Registration, NSE Corporate Membership and detailed curriculum vitae (CV), with full description of the engineering responsibilities/duties undertaken since graduation. Assessment would be as follows: 1

A. Membership Status and Professional Career Attainment 1. Are you an NSE Corporate Member? b. If yes state: i. Date of Election: ii. Corporate Membership No:. iii. Discipline:. 2. Are you a financial member? Yes/No Show the dates of your last 5 years payments of subscriptions/dues. i. ii. iii. iv. v.. 3. Are you a COREN registered engineer? b. If yes state: i. Date of Registration:. ii. Registration No:.. iii. Discipline:.. 4. Are you registered by any other internationally recognized engineering body except COREN? b. If yes state i. Body/Registration Number:.. 5. Have you held professionally recognized position (s) in your field of Engineering at State/National/International level (MD, GM, Director, Technical Adviser, Principal Partner, Dean, HOD, or equivalent post)? b. If yes, state positions, dates and responsibilities (You may use additional sheet (s) if necessary). i. ii.. iii.. iv... v... 2

B. Contribution to NSE 6. Have you attended any NSE National Annual General Meetings (AGM)? b. If yes, state dates and places (up to 5 AGMs) i... ii... iii... iv... v... 7. Have you been a member of any branch (es)? b. If yes state branch (es) and your contributions i.... ii... iii.. 8. Have you been a member of any Division (s)? b. If yes, state Division (s) and your contributions i.. ii.... iii.. C. Professional Contributions 9. State five major contributions to Engineering (financial, encouragement of Engineers in your establishment (s), sponsorship, approval of training, workshop, seminars, etc.) i. ii iii..... iv.. v... 10. State five areas where you have made significant contributions in Engineering and Technology. i.. ii.... iii.... iv..... v.... 3

11. Have you held any national office such as President of Nigeria, Governor/Deputy Governor of a State, Federal Minister, State Commissioner, Permanent Secretary or their equivalent during which time you identified yourself with Engineering? b. If yes, state 3 posts with dates. i.... ii...... iii...... D. Professional Experience 12. Have you attended any Technical or Management Seminars, Lectures, Workshops or Conferences? b. If yes, state details including dates and venues (up to 5 in the last 10 years) i.... ii.... iii... iv... v....... 13. Have you presented any Technical or Management papers for item 12 above? Or any other published engineering papers? b. If yes, give details of titles, dates and places: with copy of each (up to 3 in the past 10 years) i... ii.... iii... 14. Have you represented NSE/Engineering in any Board, Committee or Taskforce set-up by the Federal/State/Local Government? b. If yes, state name and period i...... ii...... iii..... iv...... v... 4

15. Have you played a major role in execution of key engineering projects (design/study/construction/technology development/research, etc) b. If yes, list the projects and indicate your primary role in each of them i.... ii.... iii... iv... E. Other Mandatory Requirements 16 References: must be financially up-to-date Fellows and from your Division Name/Membership No. /Signature: a..... b... Each of the referees should submit a completed Referee s Form for the candidate. 17. Have you submitted a CV showing details of your professional experience, contributions to the Society and nation, career development, attaching papers presented at local and or international conferences, and any other evidence (s) that may enhance your election? Yes/No 18. If elected, I re-affirm my pledge to comply with the constitution, Byelaws, Rules, Procedures and Codes of Ethics of the Nigerian Society of Engineers. Name:...... Signature:.... Date:... 5

The Nigerian Society of Engineers FELLOWSHIP REFEREE'S FORM 1 Name of Applicant (Block Letters) (Surname) (Other Names) 2. Address of Applicant (Block Letters) 3. Applicant s Membership No 4. Applicant s Division 5. Name of Referee 6. Address of Referee 7 Referee s Membership No 8. Referee s Division: 9. For how long and in What Capacity have you known the Applicant? 10. Comment on the Applicant's Academic Qualifications 11. Comment on the Professional Experience and Contributions of the Applicant to the Engineering Profession 12. Do you consider the Applicant to possess adequate integrity, character and professional standing for election as a Fellow of NSE? 13. I Recommend/Do not Recommend the Applicant (Delete what is not Applicable) Signature Date 6