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APPLICATION FOR REGISTRATION OF SECTION B Dear Si eer Sam sending the application for Registration of Section B duly filed-in with demand drat of Fis. 4500/- (USD 300 for overseas candidates). The information provided by me in the application are correct to the best of my knowledge. The instructions given overleaf are read by me before filling up the application form. Name & Memb. No. 2. Passed Section A in with Roll No. 1g, [Sheice of Engineering l [Code No. of Optionat . | eranch (Code No. onty Subjects Chosen Bank Draft No, dated __for Rs. Full signature of the candidate with date CERTIFICATE OF ENGAGEMENT (To be filled-in by the Engineer under whom the candidate is working) 1. Name of the orgnisation (in BLOCK letters) : 2. Address of the organisation (in BLOCK letters) 3. Nature of the organisation (markyin the relevant box) : Company Firm C1 Statutory Body Govt. Deptt.O] Public Sector UndertakingO Research Organisation) Educational Inst. OthersC] 4. Nature of activities of the organisation 5. No.of Employees | Certify that Shri/Ms . who has passed Section A Examination of The Institution of Engineers (India), is engaged/receiving training in this organisation under me sinch (designation). His date of appointment is. as. ‘Seal of the Organisation Full Signature of the Certifying Engineer & Date Designation Membership No. FIE/MIE/AMIE/AIE——_______ = (00 NOT TEAR) = ‘Specimen Signature —_». of the applicant (Preferably in English) The signature should not touch the box (Use black ink only) Supporter: Verified the photograph and signature of the applicant Namo (in Capitals) [__Membership No. Signature (preferably in English) with dato ad | Enwam : z "Note The photograph and signature are te be verified by the supporter, who must be a Corporate Member n the grade of FIEMOE/AMIE only (SEE OVERLEAF) eo @ @| IMPORTANT INSTRUCTIONS. 1. For Branch Code and Subject Codes, please reter Rules 6. In case your recorded address as printed on this format of the (vol. 1) effective from Summer 2005 examinations as per —_Identity Card (see bottom ofthe front page) is changed, please Revised Syliabi. fill up the proforma for change of address given below and enclose a separate demand draftof Rs. 150/-for the purpose. 2. A candidate Is required to send a demand draft of Rs. 4500/- (USD 300 for overseas candidates) towards 7. Demand Draft(s) should be drawn in favour of*The Insutitution registration fee with application form. ‘of Engineers (India)’, payable at Kolkata, 8. Candidate is expected to be engaged in engineering 8. Please send the filled-n application form with demand draft to profession with a registered engineering establishment. Assistant Director (EEA). The Institution of Engineers (India), 8, ‘As such the signature of the Engineer/Employing Gokhale Road, Kolkata 700 020 by registered post ‘Authority is prerequisite in the application form. superscribing on the envelope ‘APPLICATION FOR Certification by T/ST members will not be accepted. REGISTRATIONOF SECTIONB*. 4. Candidate is required o op! three optional subjects from any one group (refer Fules: Vol.) 5. Please affix one passport size photograph on the specified space for issuing Revised Identity Card for Section B Examination, CHANGE OF ADDRESS In case of any change in recorded address, fil-up the proforma Grade (ST/T) Membership No. Check-digit Name. New Address. (In BLOCK Letters) PIN CODE Enclosed Bank Draft N. dated_____of Rs. 150/- for change of address.