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ECSC Form
ECSC Form
MEMBERSHIP NO.
Name : S A P T A R S H I M O N D A L
A T I O N - M A N T E S W A R , D I S T R I C T - P U R B A B A R D H A M A N
, P I N - 7 1 3 4 2 2
Date of Birth : 1 2 0 7 2 0 0 4
Name of the Institution/ Branch of Engineering Year of Study Fees Paid (`)
Engineering College
I hereby apply for enrolment as a member of Students’ Chapter of The Institution of Engineers(India) in accordance with the rules of the Chapter and
the Bye-laws and Regulations as they now stand or hereinafter be legally altered. I do hereby undertake that I will be governed by the Bye-laws and
Regulations of the Institution. I accept the responsibility for the accuracy of the particulars contained in the above and I agree that, if I am enrolled, the
validity of the enrolment shall depend upon the accuracy of the particulars as required under the Bye-laws. I also undertake to abide by the conduct of
rules and / or Code of Ethics that the Council may prescribe from time to time
(Signature of the Adviser of the Engineering College Students’ Chapter with seal and date)
This portion to be retained by the Chapter This portion to be retained by the Student