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Graduate Membership Application Form

This document is an application form for graduate membership in the Zimbabwe Institution of Engineers. It requests information such as the applicant's name, date of birth, citizenship, education history, employer details, and engineering discipline. The applicant must indicate their sex and whether they are a current student member. A corporate member must sponsor the application and confirm the details are correct. Payment details are also included for the application processing fee and annual subscriptions.

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2K views1 page

Graduate Membership Application Form

This document is an application form for graduate membership in the Zimbabwe Institution of Engineers. It requests information such as the applicant's name, date of birth, citizenship, education history, employer details, and engineering discipline. The applicant must indicate their sex and whether they are a current student member. A corporate member must sponsor the application and confirm the details are correct. Payment details are also included for the application processing fee and annual subscriptions.

Uploaded by

rmadhlopa.hep
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
  • Application for Graduate Membership

ZIMBABWE INSTITUTION OF ENGINEERS

Conquenar House P O Box 660


256 Samora Machel Avenue East Harare
Eastlea, Tel: 746821/746652
HARARE Email: zie@zie.co.zw
www.zie.org.zw

APPLICATION FOR GRADUATE MEMBERSHIP


SECTION 1 (to be completed by the applicant in capitals)
ARE YOU A STUDENT MEMBER OF ZIE YES/NO (Delete inapplicable option)
SECTION 1 (to be completed by the applicant in capitals)
Surname Date of Birth
First name(s) National ID No.
Citizenship Tel. No. (H)
Cell No Fax No.
Postal Address
Name of Employer Position Held
E-mail Address

SECONDARY EDUCATION
Educational Institution attended From To Examinations passed

TECHNICAL/ENGINEERING EDUCATION
Educational Institution attended From To Degree, Diploma or Certificate to be obtained

Engineering Discipline ………………………………………


*If elected I would also like to be a member of the following specialist division(s).
(Please indicate with an “X” in the appropriate box)
YES NO YES NO
AGRICULTURAL DIVISION INDUSRTIAL & MANUFACTURING
BUILDING SERVICES LARGE DAMS DIVISION
COMPUTER ENGINEERING MINING & METARLLURGY
ENERGY STRUCTURAL DIVISION
ENVIRONMENT WATER & SANITATION
GEOTECHNICAL Other (Specify)
Signature of Applicant ............................………........…………… Date.…............................
SECTION 2 (to be completed by the graduate's sponsor, a Corporate Member of ZIE)
Name of Sponsor: ............................................Grade of Membership: ...........................................
I am pleased to confirm that the above applicant is currently employed by
...…………………................................................………… and that all above details are
correct. I hereby support his/her application for Graduate Membership of the Institution.
Signature:.……………............................................ Date: ...…………................................
For Official Use Only (DETAILS OF PAYMENT):
Cash/Cheque/Money Order No........................... for $……………….……....................
Breakdown:
Processing Fee $……………….……....................
Annual Subscriptions $……………….……....................
Division $……………….……....................
Newsletter & Proceedings $……………….……....................

Applicant to indicate one’s sex Male Female


with an X 1

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