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    Life Membership Form

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    Sheila Marie Omega
    This document is a life membership application form for the Philippine Institute of Civil Engineers. It requests information from applicants such as personal details, employment information, and payment details. Applicants must be endorsed by their chapter and verified by the National Headquarters. If qualified, the National Board of Directors will then approve the application for life membership. Life members will be exempt from annual dues but still required to attend conventions and pay special assessments.

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    © All Rights Reserved
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    Life Membership Form

    Uploaded by

    Sheila Marie Omega
    28 views1 page
    This document is a life membership application form for the Philippine Institute of Civil Engineers. It requests information from applicants such as personal details, employment information, and payment details. Applicants must be endorsed by their chapter and verified by the National Headquarters. If qualified, the National Board of Directors will then approve the application for life membership. Life members will be exempt from annual dues but still required to attend conventions and pay special assessments.

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    This document is a life membership application form for the Philippine Institute of Civil Engineers. It requests information from applicants such as personal details, employment information, and payment details. Applicants must be endorsed by their chapter and verified by the National Headquarters. If qualified, the National Board of Directors will then approve the application for life membership. Life members will be exempt from annual dues but still required to attend conventions and pay special assessments.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    28 views1 page

    Life Membership Form

    Uploaded by

    Sheila Marie Omega
    This document is a life membership application form for the Philippine Institute of Civil Engineers. It requests information from applicants such as personal details, employment information, and payment details. Applicants must be endorsed by their chapter and verified by the National Headquarters. If qualified, the National Board of Directors will then approve the application for life membership. Life members will be exempt from annual dues but still required to attend conventions and pay special assessments.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    PHILIPPINE INSTITUTE OF CIVIL ENGINEERS, INC.

    Unit 703, 7/F Future Point Plaza 1 Condominium,


    112 Panay Avenue, Quezon City ATTACHED
    Telephone Nos. +63 2 83765028/83981434 2X2 PHOTO
    Cell Nos. +63 9173152765 ; +63 9283410623; +639223022296
    Email: pice.org.ph / Website: www.pice.org.ph

    LIFE MEMBERSHIP APPLICATION FORM


    DATE APPLICATION CODE
    PRC REGISTRATION NO. REGISTRATION DATE
    INFORMATION
    LAST NAME FIRST NAME MIDDLE NAME

    BIRTHDATE (MM/DD/YYYY) BIRTHPLACE GENDER CIVIL STATUS

    HOME / PERMANENT ADDRESS

    EMAIL ADDRESS MOBILE NO/s. CHAPTER

    NAME OF COMPANY AND ADDRESS TEL NO/s. FAX NO/s.

    DESIGNATION

    ______________________________________
    Applicant’s Signature over Printed Name
    CERTIFICATION BY THE CHAPTER
    CHAPTER:
    DATE:__________________________
    _______________________________________________________
    Certified as to payment of ₱ 10,000.00 Certified as to applicant’s the compliance to the Life Membership Requirement

    _______________________________________ _______________________________________
    Chapter Treasurer Printed Name Over Signature Chapter Secretary Printed Name Over Signature
    Endorsed to the National Board for Approval:

    ________________________________________________
    Chapter President Printed Name Over Signature
    National Headquarters Office:
    Date Received: By:
    Verification by the National Headquarters
    ฀ No record Membership dues: ________________________ LM fee payment _______________________

    ฀ With Arrears National dues OR No. ______________________________


    Chapter dues Date ________________________________
    Member since _______________
    Reinstatement fee
    ฀ Qualified Total
    ฀ Not yet qualified
    ACTION OF THE NATIONAL BOARD OF DIRECTORS Board Meeting Date:
    Verified and Recommended for Approval: Approved by the National Board of Directors pursuant to
    Section 6, Article II of the PICE By-law

    _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ ________________ ____ _______________ _____


    20__ Chairman, Membership Committee/ 20__ National President
    National Secretary
    L M NO . DATE:

    ARTICLE II - SECTION 6 – LIFE MEMBERSHIP - Any Regular member who, at the time of his application for this classification shall have been a member in good standing of the
    Institute continuously for at least ten (10) years shall be classified as Life Member after verification and approval of his application by the National Board of Directors. Life
    membership shall thereafter become effective only upon payment of the Life Membership fee prescribed under Section 3 of Article VIII of these By-Laws. A Life Member shall
    continue to possess and enjoy all the rights and privileges of a Regular Member in good standing but shall already be exempt from the payment of annual dues and shall attend
    either the regional, midyear or annual convention at least once a year. He shall, however, still be required to pay all special as assessments levied against active members, the non-
    payment of which may result in temporary curtailment of his privileges to vote or be voted upon.

    PICE-MDB-FM-01-03/ Rev.02/Eff. Date: December 27, 2019

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