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APPENDIX D

TO BE RETURNED

THE INSTITUTION OF ENGINEERS, MALAYSIA (PAHANG BRANCH)


No. 114,Blok F, Lorong Seri Teruntum 1, Medan Warisan, 25100 Kuantan, Pahang Darul Makmur.
Tel: 09-5146230 Fax: 09-5146493 E-mail: iempahang@gmail.com

BIODATA OF CANDIDATE FOR THE OFFICE OF: _______________________


Note: Candidates are encouraged to use this format, and to restrict the information supplied under
items 9, 10 and 11(ii) altogether not to exceed 350 words

1. Name
2. Age
Affix passport size
3. Year of Election of
photo (preferably
Corporate Membership Member Fellow
black and white) (3.5
cm x 5.0 cm)
4. Academic Qualifications
5. Professional Affiliations
6. Decorations, awards etc.
7. Position or Title of Current Employment
8. Current Employer & Address
9. Brief description of career and experience

10. Special field of interest

11. Other information (involvement in Committees, Organisations, if applicable)


* delete where not applicable
Current Session Position
(i) IEM 2015/2016
IEM Pahang Council Yes/No* ..
IEM Pahang Sub-committee on:
(a) .. Yes/No*
(b) .. Yes/No*
(c) ... Yes/No*

(ii) IEM HQ / OTHER BRANCHES Session Position

(a) ... .
(b) .
(c) . .

(iii) Other Committees and office (to state)


(a) ..
(b) ..

12. Pledge
- I undertake to attend Council/Excomm/Standing Committee meetings if I am elected.
- I undertake to serve in at least 2 Standing Committees of the IEM if I am elected and shall not be
absent in three (3) consecutive meeting without valid reasons
- I understand that I will have to attend the meetings of the Standing Committees that I have indicated
above, and will accept disciplinary action by Council should I fail in my duty.
- I confirm that I comply with the requirements of Rules of the Pahang Branch Constitution.
- I hereby agree to abide by IEM Code of Conduct for Committee Members and will accept disciplinary
action by Council should I breach this.
- Other, if
any: ..

.
Signature of candidate Date

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