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FORM IETE - 1

Application Form Direct Election/Transfer to the Class of Fellow/Member/Associate Member/Associate

BIO DATA

Class of Membership Applied for

Present Class of Membership & No.
(In case of Transfer of Membership to higher category)         (attach copy of certificate)

 
Membership Services
Organisational Membership
Our Resources Membership
Associate Membership
Student Membership
Student Forum
Chartered Engineers
Forms
Name Mr/Ms/Dr./Prof./Rank/                             
(In capitals)                                          (Surname)                   (First)                        (Middle)
Father’s/Husband Name

Date of Birth                        Nationality
Mailing Address

    Pin Code  
Telephone (Off) (Res.) (FAX)
E-mail           

Initials of Proposer
 

 

 

 

 

Degree/Diploma Examining Authority Name of College/Institution Year of Passing Branch of Engg.
1. Designation/Rank * Organisation Period
From

To

2.
3.
4.
5.
         

Membership of other institutions, and Awards

Note: Each entry of the applicant including professional experience should be initialled by one of the proposers after due verification. Certificate attached should also be attested.
    * For Defence officers only.

Resume of Professional Experience (in about 100 words)
(Engineering works/Research publications/Specification)
Initials of Proposer

DECLARATION BY THE APPLICANT
FORM A (Byelaw 6)

I, the undersigned agree that in the event of my election to the membership of any class in the Institution of Electronics and Telecommunication Engineers, I will be governed by the Constitution of the Institution as it now is or as it may hereafter be altered; and that I will advance the objects of the Institution as far as they shall be in my power. Further, as a member of the Institution, I shall follow professional ethics, maintain integrity in research and publications, uphold the cause and dignity of the Institution, endeavour to be objective in my judgement and strive for the enrichment of human values and thoughts.

Provided that, whenever I shall signify in writing to the Secretary General that I am desirous of withdrawing from the Institution, I shall, after the payment of any arrears which may be due from me at the period, be free from this obligation.
Witness my hand, this dated     
                                                                                                                                                 
                                                                                                                                            Signature_____________
Encl. :    1.    Biodata
2. Certificates Copies
3. Cheque/Bank Draft No.(In favour of IETE New Delhi) dated      (Please write your name on the
 
 reverse of Cheque/Draft) drawn on for Rs. is enclosed.

PROPOSER'S RECOMMENDATION

From personal knowledge and having satisfied in respect of applicant's qualification and experience, I/we recommend him to the Council as being in every way a fit and proper person to be admitted to the Institution as F/M/AM in accordance with Byelaw No. ______________________.
Name (in Block Letters) Class & Membership No Signature with date
1.  
2.  
      FOR OFFICE US ONLY
Membership
  Mem No.     Date of Election

1.App No. _______________     2. Acknowledge on _______________________________________

3.Considered at MLCC/CM Nos. _____________________ Recommended for __________________

Dealing Assistant                                                                     Assistance Secretary (M&PR)

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