Form G: Application For Admission/transfer To Graduate Membership
Form G: Application For Admission/transfer To Graduate Membership
Form G: Application For Admission/transfer To Graduate Membership
tel: + 44 (0)20 7235 4535 fax: + 44 (0)20 7235 4294 mail@istructe.org www.istructe.org
Notes to applicants
Applicants must ensure that all parts of this form are completed accurately and legibly, that the form is signed and that certified copies of certificates regarding qualifications referred to in Section 5 are securely attached.
1 Candidates personal details (to be completed in block letters) Surname/family name: Forenames/other names: Full communication address: Title: Mr/Dr/Mrs/Miss/Ms/ other: Date of birth: Age: Telephone number (work): Telephone number (home): Telephone number (mobile): Postcode/zip code: E-mail (home): E-mail (work): Nationality: Student Membership number:
Postcode/zip code: Employment confirmation: the person completing the section below must be either the candidates present employer or the professor/head of department of your academic institution. I certify that to the best of my knowledge and belief the particulars given by the applicant are correct insofar as they relate to professional education and/or training. Name (in block capitals): Signature: Institution membership number (if applicable): Position: Date:
3 Statement by supporter I consider that, subject to the completion of the appropriate requirements, the candidate is a fit and proper person to be admitted to graduate membership of the Institution of Structural Engineers and certify that to the best of my knowledge and belief the particulars given by the candidate are correct. Signature: Name (in block capitals): Institution membership number: Length of time I have known the applicant: Class (F, M or A):
The supporter must be a chartered structural engineer. The supporter must ensure all parts of the application are properly completed by the candidate. (Where the applicant does not know a chartered member of the Institution he/she should contact the membership department for help.)
4 Membership and grade of other professional bodies eg. ICE, HKIE, etc. Please state:
5 Education (certified copies of qualification certificates, including transcripts of subjects, must be provided by applicants who are not already graduate members) A Name of academic institution eg. University of London: Full name of course and grade achieved, indicating full or part time. E.g: MEng Civil Engineering (full time): Date of commencement e.g. 01/09/04: Date of completion e.g. 01/07/08:
Yes
No
6 To be completed by candidates holding a non-accredited qualification I request that my academic qualifications be assessed against the requirements for: Chartered Membership (equivalent to accredited 4 year MEng)* Associate-Membership (equivalent to accredited 3 year ordinary degree)* * Please tick against the grade for which you wish to be assessed and ensure that full details of the course content and/or academic record accompany the application. Please ensure appropriate assessment fee is attached.
7 Supporting documentation checklist Have you included: Certified and translated photocopies of your degree certificate/s The appropriate subscription fee (refer to our website: www.istructe.org) Candidates whose courses are not accredited with the Institution need to additionally submit the following: (If you are unsure whether this applies to you please contact the membership department: membership@istructe.org) Certified and translated photocopies of your academic transcripts Academic assessment fee (refer to our website: www.istructe.org) * Your certificates/academic transcripts must be certified by your employer or supporter (see sections 2 and 3 respectively). Ask your employer/supporter to sign the photocopies of all your certificates to confirm that they are authentic copies of the originals.
8 Disability declaration I wish to inform the Institution of a disability: Disability: Signature: Date:
9 Candidates declaration and undertaking (applicants who have already signed this declaration may ignore this section) This form of undertaking is to be completed by any candidate for admission or transfer to any class of membership of the Institution other than Honorary Fellow in accordance with the provisions of bye-law 1.13.1. I have read the charter, the bye-laws and the code of conduct. Whilst I am a member I undertake to be governed by the laws of the Institution for the time being in force, and to accept as final and binding decisions of the executive board and the Institution on all matters in which they have jurisdiction. I also undertake to promote the objects of the Institution; to attend Institution meetings as often as I conveniently can, and to endeavour to present to the Institution an original communication relating to structural engineering. I further undertake that, upon the cessation of my membership, I will cease to describe myself in any way as a member of The Institution of Structural Engineers. I have no criminal conviction unspent within the relevant jurisdiction. I am not subject to a bankruptcy order, restriction or undertaking. I have not been subject to an adverse finding by another organisation. There is no further matter that may affect consideration of my application. I agree to the Institution processing data relating to my membership and (where necessary) transferring such data outside the United Kingdom. Signature: Date:
tel: + 44 (0)20 7201 9131 fax: + 44 (0)20 7235 4294 membership@istructe.org www.istructe.org
I, hereby authorise the Institution of Structural Engineers to debit my credit card to the value of Card type i.e. VISA/MasterCard: Card Number: Start date (if applicable): Please tick the box if you require a receipt for payment Signature: Date: Expiry Date: Issue number (if applicable): Security Code (last 3 digits on the signature strip):
For office use only: Membership no: Payment for: Annual subscription ICP(AQP) fee Exam fee Application fee Technical report (A) Other ECUK fee Technical report (B) PRI fee Late fee