Download - Member Lifemember
The Institution of Civil Engineers (India)
Regd.: Office: 'Career House' Bindra Complex, Model Town, Ludhiana (Punjab),
Regional Office: 'Career House' 4, East Park Road, Karol Bagh, New Delhi -110005.
Email: [email protected], Website: www.ice.net.in
Application Form of Corporate Membership (MICE(I))
6. Highest Qualification:_______________________________________________________________________________
7. Total Experience in the appropriate field:_______________Years (Experience after Graduation _____________ Years)
8. Educational Qualifications (Engineering only):
S.
No.
Examination
Passed
Discipline Name of
College
Percentage
Marks
Name of
University/
Institution
Year of
Passing
Authenticated by Hon.
Fellow/ Fellow/Head,
Inst. Member/ Member
1. B.E/ B. Tech/
B. Arch.
2. M.E./M.TECH/
M. Arch
3. Ph. D.
4. Any Other
9. Details of Experience:
S.
No
.
Post Held Name & Address of the Employer From To
(Date) (Date)
Authenticated by Hon.
Fellow/ Fellow/Head, Inst.
Member/ Member
All changes (address, contact no. etc) may please be intimated for updation for prompt contact/ delivery of mail from ICE(I)
10. Details of Membership in other Institutions/ Professional Societies:
S.
No.
Grade of membership & Number Name of Institution/ Society
11. Details of Fee Paid: Rs.:_________________(Rupees:_____________________________________)
Vide DD No. _______________________ Dated: ______________ in favour of
ICE(I), drawn on _______________________ in ____________________. Name of Branch Name of the Bank
Date: ______________
Place:______________
Signature
Note:
1. DD to be drawn in favour of ICE(I) payable at Ludhiana. 2. Please write your name, membership no., if any, address on the back of the DD
Undertaking
1. I hereby apply for admission as a Member of the Institution of Civil Engineers (India) in accordance with the Rules & Regulations and the Bye-laws as they stand now or may be amended from time to time.
2. The particulars contained in the application form are true as I understand that the validity of my admission depends upon the accuracy of these particulars.
3. I undertake to abide by professional conduct rules and/or code of conduct that the institution may frame from time to time.
4. The decisions of the institution in granting me the Membership shall be final and binding on me. 5. I shall regularly renew my membership by paying annual subscription fee. 6. I shall promote the objects of the Institution as far as may be in my power. 7. In the event of invalidity of my Membership for any reason I shall forthwith cease to describe my self as a
Member of the ICE(I). 8. If I withdraw my Membership from the Institution I shall do so after payment of any arrears that may be due from me to
be free from this obligation. Signature
Attested
Corporate Members, ICE (I)
Signature & Membership No.
Endorsement by the Sponsors
Name Membership Number, ICE(I)
1. Important Note:- All members should note the following (Except Life Members):
1. If membership is not renewed for two years, the membership may be suspended.
2. If membership is not renewed for three years, the membership may be cancelled and candidate be asked to
surrender the Membership Certificate.
(FOR OFFICE USE OF ICE(I)) Received with thanks duly filled in Application Form for Fellow/ Members from……………………. alongwith DD
No……………………. for Rs…………………. Towards Membership Fee and Subscription Fee (Annual) for the
year………………………..
Authorised Signatory
ICE(I)
____________________________________________________________________________________________
Approval to the Membership
Chairman/Secretary
ICE(I)
Fee Structure
Membership Annual Subscription Life Membership Fee Fee Fee
Rs. 500/- + Rs. 500/- or Rs. 5000/-
(Payable alongwith the Application Form)
Membership No______________