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The Institution of Engineers (India) : (Application For Issuance of Photo Identity Card)

This document contains an application for issuance of a photo identity card from The Institution of Engineers (India). It requests that the applicant return the filled out original and duplicate application, along with a draft of Rs. 250 towards the fee for the photo identity card. Spaces are provided for the applicant's name, membership number, mobile number, passport size photograph, and specimen signature, as well as verification by a supporter who is an existing corporate member of The Institution of Engineers (India).

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Phani Kumar
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29 views1 page

The Institution of Engineers (India) : (Application For Issuance of Photo Identity Card)

This document contains an application for issuance of a photo identity card from The Institution of Engineers (India). It requests that the applicant return the filled out original and duplicate application, along with a draft of Rs. 250 towards the fee for the photo identity card. Spaces are provided for the applicant's name, membership number, mobile number, passport size photograph, and specimen signature, as well as verification by a supporter who is an existing corporate member of The Institution of Engineers (India).

Uploaded by

Phani Kumar
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
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Please return the application duly filled in (both Original and Duplicate)

The Institution of Engineers ( India)


8 GOKHALE ROAD, KOLKATA 700 020
Tel No. (IVRS) : (033) 40155400, Fax No. (91)(033) 2223-8345, E-mail : membership@ieindia.org

Original

(Application For Issuance of Photo Identity Card)


Dear Sir,
Please find enclosed a draft of Rs. 250/- (US $ 25 for members residing/working in abroad) towards the fee for Photo
Identity Card.
Please arrange to issue me the Photo Identity Card.
Signature ____________________________________
Encl : Draft No. __________________

For Office Use


Name in Capitals

[Surname]

[Remaining Name]

Membership No. A/AM/M/F ____________ - ___

Mobile No. ______________

Specimen Signature
(* in English only)
Passport or stamp
size photograph to be
pasted here
(do not sign on the
photograph)

The signature should not touch the box


(Use black ink only)

Signature * Attested

* In case of regional language, signature attestation is a must by a


Gazetted Officer with Seal

Supporter : Verified the photograph and signature of the applicant


Name (in Capitals)

Membership No.

1.................................................................

F/M/AM .............................................

Signature (in English only) with date


.................................................................

Note : The Photograph and signature are to be verified by the supporter who is an existing Corporate Member (F/M/AM).

The Institution of Engineers ( India)


8 GOKHALE ROAD, KOLKATA 700 020
Tel No. (IVRS) : (033) 40155400, Fax No. (91)(033) 2223-8345, E-mail : membership@ieindia.org

Duplicate

(Application For Issuance of Photo Identity Card)


For Office Use
Name in Capitals

[Surname]

[Remaining Name]

Membership No. A/AM/M/F ____________ - ___ Mobile No. ______________


Specimen Signature
(* in English only)

The signature should not touch the box

Signature * Attested

(Use black ink only)

Passport or stamp
size photograph to be
pasted here
(do not sign on the
photograph)

* In case of regional language, signature attestation is a must by a


Gazetted Officer with Seal

Supporter : Verified the photograph and signature of the applicant


Name (in Capitals)
1.................................................................

Membership No.
F/M/AM .............................................

Signature (in English only) with date


.................................................................

Note : The Photograph and signature are to be verified by the supporter who is an existing Corporate Member (F/M/AM).

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