Engineer Application Form - PDF by iei93687

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									CHARTERED ENGINEER
ApplICATIoN FoRM
STEp 1: pERSoNAl AND EMploYMENT DETAIlS                                      STEp 2: SpoNSoRS
All sections of this form must be typed or completed in black ink in         Applicants for CEng registration should be sponsored by two
block letters. If the form is incomplete, this will delay your application   Chartered Engineers registered with the Engineering Council (UK)
and the form may be returned to you.                                         and personally familiar with the work of the applicant. Sponsors
                                                                             must also complete the separate sponsor form.
Please indicate whether you are applying to become a Chartered
Engineer (CEng) Member or Fellow                                             I will be supporting this application and thus recommending the
                                                                             applicant to the Trustee Board as worthy of membership. Having
Designatory letters                                                          read the By-Laws, I am of the opinion that the applicant should be
eg BEng, OBE                                                                 considered for election to the class indicated.

Membership number
(if already a member)                                                        Sponsor 1
Title: Mr/Mrs/Miss/Ms/Dr                                                     Title: Mr/Mrs/Miss/Ms/Dr
Forename                                                                     Forename
Surname                                                                      Surname
Date of birth                                                                Date of birth
Home address                                                                 Membership / ECUK number
                                                                             Class of membership and Institution
                                                                             (if not IMECHE)

Country                                                                      Address

Postcode
Home email
Home tel                                                                     Country

Mobile                                                                       Postcode
                                                                             Email
Work address                                                                 Signature




Country                                                                      Sponsor 2

Post code                                                                    Title: Mr/Mrs/Miss/Ms/Dr

Work email                                                                   Forename

Work tel                                                                     Surname

Fax                                                                          Date of birth

Mobile                                                                       Membership / ECUK number
                                                                             Class of membership and Institution
                                                                             (if not IMECHE)
                                                                             Address




                                                                             Country
                                                                             Postcode
                                                                             Email
                                                                             Signature
STEp 3: ACADEMIC QUAlIFICATIoNS
This relevant parts of this section must be completed in full.

Initial qualification
University
Degree designation
(eg BEng/MEng)
Full title of degree-as it appears on your certificate
(eg Mechanical Engineering)
Course type
(eg F/T, P/T, sandwich)
Degree classification
(eg 2.1 Hons)
Date of admission to course
Which year did you enter the degree
1st / 2nd / 3rd / 4th
Date of graduation


post graduate qualification (if any)
University
Degree designation
(eg MSc, PhD)
Full title of degree
(eg Aero Engineering)
Course type
(eg F/T, P/T)
Degree classification
(eg Pass, Distinction)
Date of admission to course
Date of graduation



STEp 4: pRoFESSIoNAl ExpERIENCE
Overview of present appointment.
Name of employing organisation
Job title
Nature of business
Date appointed


Brief outline of your organisation - describe what you do. Detail your
personal responsibilities. Please make full use of the space provided.
STEp 5: CAREER To DATE
Give the names of employers, positions held, dates and
a brief description of your role in chronological order.
Please make full use of the space provided.




                                                           STEp 6: INTERVIEW loCATIoN
                                                           Indicate three locations of your choice in the order of preference
                                                           where 1 is your first choice.

                                                           London
                                                           West Midlands
                                                           Bristol
                                                           North West
                                                           East Midlands
                                                           Newcastle
                                                           Aberdeen
                                                           Glasgow
                                                           Belfast
                                                           Overseas (please specify)
                                                           In-company scheme (please specify)
STEp 7: INDUSTRY ClASSIFICATIoN                                STEp 8: DATA pRoTECTIoN ACT
Please indicate your current areas of engineering activities   IMechE will hold your personal data (for example, your contact details,
(no more than three areas should be identified).               areas of engineering interest and details of your academic record and
                                                               employment experience/history) on its computer database.
   Aerospace                                                   This information may be accessed, retrieved and used by IMechE
   Army                                                        and its associates for normal administrative purposes (for example,
                                                               processing your membership application/renewal and contacting
   Automobile industry                                         you in respect of your membership) and conducting market research.
   Bio-medical                                                 If you are based outside the European Economic Area (the “EEA”),
                                                               information about you may be transferred outside the EEA.
   Building services
                                                               IMechE may also periodically send you information on events,
   Computers & IT in engineering                               conferences and publications you may be interested in. If you do not
   Consulting engineers / Local Gov’t                          wish to receive such information, please tick this box.

   Control & instrumentation                                   IMechE may also provide your personal information to carefully
                                                               selected third parties (a list of whom is available on request) in order
   Defence industry systems
                                                               to provide you with information for non-IMechE events, conferences,
   Environmental man. Systems                                  publication and various affinity benefits. Where possible, the
                                                               information sent to you by third parties will be targeted to focus
   Gas industry
                                                               on your likely interests. However, if you do not wish to have your
   Gov’t inspectors & engineers                                personal details used in this way, please tick this box.
   Health and safety officers
   Higher education
                                                               STEp 9: ENGAGEMENT
   Machine tools
   Maintenance engineering                                     To be signed by applicant. Please read carefully.

   Management consultants                                      I, the undersigned, certify these statements are true, and do hereby
                                                               agree that in the event of my election I will be governed during my
   Manufacturing industries                                    membership by the Royal Charter and By-Laws of IMechE, as they are
   Mining and quarrying                                        now formed or as they may hereafter be altered, and that I will not use
                                                               any titles, abbreviated titles or descriptions associated with IMechE
   National health service                                     except those to which I am entitled under the By-Laws.
   Nuclear engineering                                         I further undertake that I will pay an annual subscription as prescribed
   Oil industry & offshore engineers                           in the By-Laws, and if at any time I shall desire to withdraw from the
                                                               Institution, I will forthwith pay all arrears of subscription or other
   Power / Non-nuclear                                         payments due from me.
   Process industries
   Railway engineering
                                                               Signature
   Royal navy
                                                               Date
   Royal air force
                                                               Please return completed forms to:
   Shipping & general insurance
                                                               Membership applications
   Steel production / drilling                                 IMechE
   Telecommunications                                          1 Birdcage Walk
                                                               London SW1H 9JJ
   Water industry                                              T 0845 226 9191
   Other (please specify)                                      F 020 7090 1001
                                                               E membership@imeche.org
                                                               Overseas callers +44 (0)20 7090 1078
                                                               www.imeche.org




                                                               For office use only
                                                               Fee received                           IPD not OK
                                                               AAC Case no                            IND
                                                               ACK                                    INT
                                                               Q 1st                                  PRC
                                                               Q 2nd                                  Other
                                                               NQ 1st                                 Date
                                                               NQ 2nd                                 Signed
                                                               IPD OK

								
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