Confederation of Engineers ( India )

Second Floor, West Wing,

PMT Building, Hadapsar,
Pune 411028, Maharashtra ( India ). I Chapter-----------------------------------
Phone : + 91 20-65784693 , +91 9028686786.
E-mail: postmasterceindia@rediffmail.com Referred by------------------------------
Website : www.ceindia.org

MEMBERSHIP APPLICATION FORM

To, Photograph of
applicant
The Hon.Gen.Secretary,
Confederation of Engineers (India),

Please enroll me as Fellow / Member/ Student/ Member under the category of (Please Tick)

Architectural Engineering Aeronautical Engineering Agricultural Engineering

Chemical Engineering Civil Engineering Electrical Engineering Electronics Engineering
Industrial Engineering Production Engineering Mechanical Engineering
Metallurgical Engineering Mining Engineering Marine Engineering Structural Engineering
Nuclear Engineering Textile Engineering Tools Engineering Public Health Engineering
Foundry Engineering

Name of the Applicant ( Mr./ Mrs./.Ms./Dr./Others )

Name of Establishment Firm

Designation : Proprietor Partner Associate Director

Date of Birth Age Years Gender - Male / Female

Permanent Address Present Address

Telephone Telephone
Mobile No. : E mail:
( Please Tick mark appropriate for correspondence address.)

Educational Qualification: ( Give Details of School, College Name and University )

Experience : ( if any ) Please attach separate sheet

If you belong to any other association / society / institution please list them here
 Please enter the attached documents below
Encl:

Structure of Fees :
LifeTime Membership Fees For Certified Engineer Title ( C.Eng.) : Rs. 10,000 /-
LifeTime Membership Fees For Chartered Engineer Title ( C.Eng.) : Rs. 15,000 /-

UNDERTAKING :
In the event of my selection to any grade to membership of the Confederation of Engineers ( India ),
I promise to abide by the constitution, code of ethics and Bye-laws of the Confederation of Engineers
( India ). I declare that the particulars given above are true & correct to the best of my knowledge.

Signature of Applicant ( in full )

FOR OFFICE USE ONLY :

Application verified by : Hon.Gen.Secretary and found correct.

Application approved at the Executive Committee Meeting held on

Membership No. Allotted

Received Cash/ Cheque / Demand Draft of Rs. /- No. Bank

Instructions For Filling Up The Form :

Fill up entire form in Capital Letters Only,

Attach Certified/ Attested copies of other institutional memberships also,

Affix latest passport size photograph on the application, another two photographs,

Please inform change of address for correspondence, if changed any time during the Membership to avoid
inconvenience to each other,

Fees once paid not Transferable or Refundable,

Demand Draft should be in favour of Confederation of Engineers ( India ), Payable at Pune.