Membership Application Form If you require assistance or advice please telephone +44 (0)1438 765678 or visit www.theiet.org/contactmembership. Your annual subscription must accompany this form. Your subscription year will run annually from the date that you joined the Institution of Engineering and Technology. Please send the completed application form to: Member Assessment Team, The IET, Michael Faraday House, Six Hills Way, Stevenage, Herts SG1 2AY UK. PLEASE USE BLACK INK AND WRITE CLEARLY IN THE BOXES IN BLOCK CAPITALS. ALL FIELDS ARE MANDATORY. PLEASE COMPLETE ALL FIELDS TO AVOID ANY DELAY IN PROCESSING YOUR APPLICATION.

Your Details Personal Details Title

First Name(s)

Surname/Family Name

Date of Birth

d

d

m

m

y

y

y

y

Home Address

County/State

Postcode

Home Telephone

Personal Mobile

Country

Home Email Address Employer Details Job Title

Employer’s Name

Work Address

County/State

Postcode

Work Telephone

Work Mobile

Country

Work Email Address

Preferred Name for Membership Card e.g. Mr A Jones Please specify the address that you would like all correspondence sent to:

Home

Work

Please specify your gender:

Male

Female

Membership Number (only required for previous Associates or Members wishing to re-join the IET): Is your membership fee being funded by your employer?

Yes

No

If yes, please ensure you have completed the work details section above.

Web username (if applicable) Data Protection I understand and consent to the information provided on this form being processed by the IET for its sole use and that of its associated organisations, including my Local Network, for the purpose of promoting, delivering and improving my experience of the IET and its product and services or such other purposes as are described in the IET Privacy Statement. If either now or in the future I am based outside the European Economic Area (the “EEA”), my information may be transferred outside the EEA (for example to my Local Network or IET Global Office) to enable me to benefit from the IET opportunities overseas or, where required, to enable the IET to meet any legal or other legitimate obligations in that country. IET products and services are enjoyed by our members and customers globally. However if you do not wish to receive notification of products and services which may be of interest and benefit to you (by post or electronic means) please tick this box.

Membership Details Membership Category Options

To find out about the requirements for each category of membership visit www.theiet.org/membership/types

Member Application Section

Please refer to the guidance notes on the IET website www.theiet.org/requirements for further guidance in completing this section

I wish to apply for Member with the designatory letters MIET. I wish to apply for Associate

I wish to apply for Member with the designatory letters TMIET.

Qualifications Please provide details of engineering or technology qualifications you hold or are in the process of completing in the table below (if you are applying for either the Advantage or Signature membership programme this section must be completed in full): Award/Course e.g. BEng, MSc, NVQ3 etc

Course Title e.g. Electrical Engineering, Computing etc

Name of University/College/Awarding Body and Country

Period of Study (start and end date)

Work Experience Depending on the Qualification that you hold we may need to assess your work experience to determine your eligibility for the level of membership selected. Following the assessment of your qualifications, we may contact you to provide a CV that clearly details your present employment position, previous employment positions, roles and responsibilities together with any other qualifications that are relevant to the interests of the IET.

Supporter’s Details Depending on the Qualification that you hold you may need a supporter. Your supporter can be your employer/line manager, a Member of the IET or someone that knows you in a work capacity e.g. client, previous employer etc. If you cannot find a suitable person to support your application, or have any queries please contact the Membership Services Team on +44 (0)1438 765678. My supporter is not currently available to complete this section. Please contact me later to provide this information. Title

First Name(s)

Surname/Family Name Line Manager

Job Title CEng

IEng

EngTech

ICTTech

Associate

TMIET

MIET

FIET

Please detail membership of other Institutions e.g. MIMechE, MIEAust: IET Membership No. (if applicable)

Web username (if applicable)

Address for communication

County/State

Postcode

Telephone

Mobile

Country

Email Address In my opinion this person has achieved the required knowledge and understanding and is a suitable candidate to become a Member of the IET and use the letters MIET*

or

TMIET*

after their name

(*please select as appropriate)

Signature of Supporter

Date

d

d

/

m

m

/

y

y

y

y

The IET will contact your supporter for further background to your application for membership. It is not IET policy to disclose comments made by supporters and we would recommend applicants to discuss their membership application with the supporter prior to submission.

Declaration I declare that the statements made on this form are to the best of my knowledge true. I agree to comply with the Royal Charter and Bye-laws and Rules of Conduct of the Institution of Engineering and Technology (IET) and understand that this is a commitment to behave ethically within my profession. I will do my best to promote the interests of the IET. I confirm that I have not committed any offence of which the IET would require me to give notice under its Rules of Conduct. The Rules of Conduct and the Royal Charter and Bye-laws are published on the website www.theiet.org/byelaws and the Terms and Conditions of Membership can be found www.theiet.org/membership-terms

Signature

Date

d

d

m

m

y

y

y

y

V3.0

Membership Application Form - The IET

opportunities overseas or, where required, to enable the IET to meet any legal or other legitimate obligations in that country. IET products and services are ...

85KB Sizes 0 Downloads 375 Views

Recommend Documents

2013 Membership Application Form -
Home Country/State: Undergrad ... Musical Director and the committee, and that failure to pass an audition will result in the termination of membership. Should.

Membership Application Form 2017.pdf
There was a problem previewing this document. Retrying... Download. Connect more apps... Try one of the apps below to open or edit this item. Membership ...

2016 membership application form
NEW NON-STUDENT APPLICATION ____. NON-STUDENT RENEWAL ____. DATE (mm/dd/yy): _____/____/____ CHECK ENCLOSED ____ PAID by PAYPAL ...

Application for GLSC Membership Form - Updated April 2011.pdf ...
There was a problem previewing this document. Retrying... Download. Connect more apps... Try one of the apps below to open or edit this item. Application for ...

ICC, MEMBERSHIP APPLICATION FORM (1).pdf
There was a problem previewing this document. Retrying... Download. Connect more apps... Try one of the apps below to open or edit this item.

APPLICATION FORM FOR MEMBERSHIP 2.pdf
your recent. passport size. photo. CENTRE FOR Excel India JAM. Formula One CS Focus. Page 1 of 1. APPLICATION FORM FOR MEMBERSHIP 2.pdf.

MeMbership application
please complete and forward to aFcoM: 742 e. chapman ave., orange, ca 92866 or fax (714) 997-9743. ®. NAME: TITLE: COMPANY: ADDRESS: CITY/ST/ZIP:.

ADP Membership & ADP Design Tour in Bangkok Application Form ...
ADP Membership & ADP Design Tour in Bangkok Application Form.pdf. ADP Membership & ADP Design Tour in Bangkok Application Form.pdf. Open. Extract.

Membership Application 2016-2017 Return this form to ...
Membership Application 2016-2017. Return this form to any Executive Board Member It's never too late to join! Membership Fee- $26. PLEASE PRINT CLEARLY. NAME: ...

Application Form for Membership-Aug-12 -
Membership of “Dwarka Forum”. I/We hereby confirm that I/We am/are the bona-fide Resident / Regd. Body of Dwarka Sub-city, New Delhi and also I/We am/are regularly residing in the above mentioned address with my family members. Contact Details: P

membership application
MEMBERSHIP APPLICATION. PERSONAL INFORMATION. Name: Institutional affiliation and position (if any):. Address: E‐mail address: We will never pass personal information (incl. contact details) on to third parties. MEMBERSHIP PACKAGE. Please tick appr

membership application
or fax (714) 997-9743. ®. NAME: TITLE: ... CITY/ST/ZIP: PHONE: FAX: EMAIL: PAYMENT: PAYMENT METHOD. Check Enclosed ... St. Louis (Gateway). $25.00.

Membership Form of ICRI14 - MSBIRIA
PLEASE ATTACH ONE PAGE BIO-DATA WITH THIS FORM. DECLARATION. I, (full name) ... or amended from time to time. Date:______ Signature of Applicant: ...

Membership Form Hindi.pdf
There was a problem previewing this document. Retrying... Download. Connect more apps... Try one of the apps below to open or edit this item. Membership ...

membership application
Email Address: Date of Birth: Parent/Guardian's Driver's Licence Number: Expiry Date: Minor's Target Pistol Number: ... Signature of Parent or Guardian: ...

ONW Membership Form -
These forms can also be delivered to the OBSID office in 21 Lower Main Road or to the Library in Station Road. You can also scan the completed form and email ...

Membership Application & Levels.pdf
Membership Investment $200 $1,000 $2,500 $5,000 $10,000. Page 2 of 2. Membership Application & Levels.pdf. Membership Application & Levels.pdf. Open.

TLCA Membership Application -
A service charge of. $15.00 will be assessed for all returned checks. Comments to Staff: Yes! I want TLCA to automatically renew my membership every year.

application for membership
Associació Catalana de. Mares, Pares i Tutors d'Infants Anglòfons. English-Speaking. Children's Parents' and. Guardians' Association of Catalonia.

application for membership
By signing this application, I authorize the Association, (including local, state and national) or their subsidiaries or representatives to fax, e-mail, telephone or ...

Application for Membership
original application to the International Executive Office of the Fraternity within ten days of the initiation ... Permanent Phone Number ... Executive Office Use Only.

Junior Membership Form 2017.pdf
Date received. Payment received. Accepted/Declined. Election date. Page 2 of 2. Junior Membership Form 2017.pdf. Junior Membership Form 2017.pdf. Open.

Membership Renewal Form 2017.pdf
KELAB RENANG IKAN BILIS, HONG LEONG BANK BERHAD, AC NO. 32100000386. Please indicate in Ref :Swimmer's Name 2017 Renewal and email bank ...

PTA Membership Form Spanish.pdf
le permite hqcer un impocto inmedioto o trov€,s de su contribuci6n pertenencio ol poner los fondos en los. progromas de oula y de la escuelo de su hijo.