THE INSTUTUTION OF ENGINEERS, BANGLADESH

HEADQUARTERS : RAMNA, DHAKA-100 Affix 2 attested

Founded in 1948, Registered under Act XXI of 1860 recent P.P. size
Recognised by the Government of the People's Republic of Bangladesh photo here
Phone:9566336, 9559485, 9556112, Fax:880-02-9562447
E-mail: info.iebhq@gmail.com, info@iebbd.org; Web:www.iebbd.org

APPLICATION FORM FOR MEMBERSHIP (Fellow, Member, Associate Member)

(All relevant spaces must be filled in)

FOR OFFICIAL USE

1.0. PERSONAL INFORMTION
Scroll No:
1.1. NAME Date of Receipt:
Acknowledgement:
(on next birth date)
1.2. DATE OF BIRTH 1.2.1. AGE Copies of Certificates
Years
Copies of Transcripts
D D M M Y Y Y Y
Photo Enclosed Y N
1.3. NATIONALITY 1.2.2. PLACE OF BIRTH
Professional Record Enclosed
Recommendation Y N
Applied for F M AM
1.4. MAILING ADDRESS
Name & Signature
(With postal code)

Evaluated by Membership Section

1.5. PERMANENT ADDRESS Age
(With postal code) Education
Experience
Recommendation
1.6. PHONE OFFICE RESIDENCE Name & Signature

MOBILE E-mail

1.7. GENDER MALE FEMALE (please tick as ) Chairman/Member Secretary/Member,

Membership Committee
1.8. MEMBERSHIP APPLYING FOR Accepted Rejected
1.9. PRESENT IEB MEMBERSHIP NUMBER (if Name & Signature
any) F/M

2.0. EDUCATION (enclose attested photocopies of certificates)

EQUIVALENT YEAR OF DIV/CLASS

INSTITUTE BAOARD/UNIVERSITY
LEVEL PASSING GPA/CGPA

SSC/Equivalent

HSC/Equivalent

B.Sc. Engg./Equivalent

M.Sc/Ph.D/Equivalent

Transcripts
i) HSC/Diploma
ii) B.Sc. Engg.

3.0. FIELD OF ENGINEERING : Please Tick in Division, Write Sub-Division(if any)

Division Civil Mechanical Electrical Chemical Agricultural Computer Textile

Sub-Division
 4.0 PROFESSIONAL RECORD (If Necessary enclose separate page)

SL. PERIOD(Date)
DESIGNATION EMPLOYER BRIEF JOB DESCRIPTION
NO. FROM TO

5.0 Please enclose attested copies of certificates of other professional bodies including Membership no.(if any)

6.0 DECLARATION : I declare that the information I have appended herewith and the documents enclosed are complete and
correct. If enrolled, I shall conform to the constitution, bye-laws, rules and regulations of the Institution and to the code of
Ethics.

D D M M Y Y Y Y Signature of the applicant

7.0 RECOMMENDATION : I recommend him for the class of membership applied for:

NAME (in block letters) MEMBERSHIP NO. SIGNATURE DATE

Proposer

Seconder I

Seconder II

Note (I) :Proposer and Seconder must be at least (i) Two Fellow and one Member for Fellowship (ii) One Fellow and two Members for Membership
(iii)Two Members for Associate membership
Note(II) :All necessary documents and photo must be attested by Proposer or Seconder

Approved in the ............th Central Council Meeting Countersigned by

held on .................................................................
Chairman Membership Committee Member Secretary

8.0 INFORMATION FOR APPLYING FOR MEMBERSHIP OF THE IEB

Subscription Rate Others

Category Entrance Annual Diploma Total Age in
Experience(Minimum)
Fee(Tk.) Subscription(Tk.) Fee(Tk.) (Tk.) years (At least)

10 years
Fellow 400.00 600.00 100.00 1,100.00 35
15 years(if Non Member)

3 years (in Non Member)

Member 200.00 350.00 100.00 650.00 25
2 years (if Associate Member)

Associate B. Sc. Engg.

125.00 175.00 50.00 350.00 -
Member Or Equivalent
1.Photo PP Size (2copies) 3.Transcripts: HSC/Diploma. Engg.
Pl. Enclose attested copies
2.Certificate: SSC, HSC, BSc. in Engg. 4.Certificates of other Professional Bodies(if any)