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  • UIPE Student Membership Application Form 4

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    Opendi Charles
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    This document is an application form for student membership with the Uganda Institution of Professional Engineers. It requests information such as the applicant's name, registration number, date of birth, nationality, university/college attending, course of study, expected graduation year, and contact details. It also includes a section for a university official to verify the applicant's student status and program of study. Finally, there is a section for UIPE official use to record the application review and approval process.

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    UIPE_Student_Membership_Application_Form_4

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    This document is an application form for student membership with the Uganda Institution of Professional Engineers. It requests information such as the applicant's name, registration number, date of birth, nationality, university/college attending, course of study, expected graduation year, and contact details. It also includes a section for a university official to verify the applicant's student status and program of study. Finally, there is a section for UIPE official use to record the application review and approval process.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    18 views1 page

    UIPE Student Membership Application Form 4

    Uploaded by

    Opendi Charles
    This document is an application form for student membership with the Uganda Institution of Professional Engineers. It requests information such as the applicant's name, registration number, date of birth, nationality, university/college attending, course of study, expected graduation year, and contact details. It also includes a section for a university official to verify the applicant's student status and program of study. Finally, there is a section for UIPE official use to record the application review and approval process.

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    © All Rights Reserved
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    of 1

    UGANDA INSTITUTION OF PROFESSIONAL ENGINEERS Affix your

    P. O. Box 1308, KAMPALA passport size


    photograph
    Tel: 041-287292 E-mail: info@uipe.co.ug here

    APPLICATION FORM FOR STUDENT MEMBERSHIP


    SECTION A
    To be filled by the Applicant
    FULL NAME (Surname First) ……………………………………………………………
    REG. NO.……………………..SEX.……………DATE OF BIRTH………………….…
    AND BEING…………………………..YEARS OF AGE.
    NATIONALITY……………………………………………………………………………
    UNIVERSITY/COLLEGE WHERE REGISTERED………………………………………
    COURSE BEING FOLLOWED……………………………………………………………
    DURATION OF COURSE ………………….............YEAR OF REG).….........................
    PRESENT YEAR OF STUDY (1st, 2nd,3rd,4th) ................................
    EXPECTED YEAR OF GRADUATION ……..........................
    ADDRESS (FOR CORRESPONDENCE)…………………………………………………
    ………………………………………………….…………………………...………………
    Tel.: ……………………………… E-mail:………………………………………………
    SIGNATURE ………………………………… DATE ………………………………….
    ………………………………………………………………………………………………

    SECTION B
    To be filled by the Relevant University/College Official (e.g. Faculty Dean, Head of
    Department, etc.).
    I certify that…………………………………………………………………. is a registered
    student at this University and is following a programme of study leading to the award of
    …………………………………………………………….………………………………..
    SIGNATURE …………………………………………… DATE ………………………..
    NAME ………………………………………………….. TITLE …………………………

    OFFICIAL STAMP
    SECTION C
    For UIPE official use only:
    Recommended for election by MET on ………………………………….………………...
    Elected by Council on ……………………………………………………………………...
    UIPE Student Membership number ……………………………………………………….

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