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Student Membership 2014 Application

This document is an application for student membership of the Institute of Highway Engineers. It requests information such as the applicant's name, contact details, engineering qualifications, membership of other professional bodies, area of specialism, and a statement agreeing to abide by the Institute's codes of conduct. Upon completion, the applicant's signature and payment details are required to finalize the application.

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Syed Omer
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0% found this document useful (0 votes)
43 views1 page

Student Membership 2014 Application

This document is an application for student membership of the Institute of Highway Engineers. It requests information such as the applicant's name, contact details, engineering qualifications, membership of other professional bodies, area of specialism, and a statement agreeing to abide by the Institute's codes of conduct. Upon completion, the applicant's signature and payment details are required to finalize the application.

Uploaded by

Syed Omer
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FOR STUDENT MEMBERSHIP (TYPE or BLOCK CAPITALS please)

Surname:

Current Employer:

Forenames:
Home address:

Business address:

Tel:
Email:
Job Title:
Preferred address for correspondence:
Home
Business

Tel:
Mobile:
Email:
DOB: dd/mm/yyyy
Title (Mr/Ms/Miss/Mrs):

Engineering Qualifications (please list all relevant qualifications & attach copy parchments if applicable)
Qualification
Awarded

Grade
Awarded

Institution/University

Duration
of
course

Full time/ Part


time

Discipline

Entry Year

Graduation
Year

Membership of other Professional Bodies


Name of Organisation

Abbreviated title

Current or past

Year of admission

Area of specialism: (tick up to three boxes)


Accident investigation
Bridges/Structures
Contracts Management
Development Control

Drainage
Highway Engineering
Highway Construction Maintenance
Highway/Road Design

Planning
Surveying
Traffic Engineering Management
Traffic Signs/Signals

OTHER:.
ATTACH A COPY OF YOUR CURRENT STUDENT IDENTIFICATION. Eg Scanned copy of your student card

Statement by Applicant
I hereby apply for membership of the INSTITUTE OF HIGHWAY ENGINEERS and enclose the fees listed on my
completed Payment Form. I declare that the information I have given is complete and correct. I will abide by the Articles,
Bye-Laws and Rules of the Institute and by the Codes of Conduct of the Institute and of the Engineering Council when I
am registered. I undertake to meet my professional development commitments and I will promote the objects of the
Institute to the best of my ability.

Signature:
FOR OFFICE USE ONLY:
Date received:
Date acknowledged:

Date:

Amount Paid:
CV received:

P-No:
M-Ship No:

INSTITUTE OF HIGHWAY ENGINEERS, De Morgan House, 58 Russell Square, London, WC1B 4HS.
Tel: 020 7436 7487 Fax: 020 7436 7488
Email: [email protected]

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