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THE INSTUTUTION OF ENGINEERS, BANGLADESH

HEADQUARTERS : RAMNA, DHAKA-100

Affix 2 attested
recent P.P. size
photo here

Founded in 1948, Registered under Act XXI of 1860


Recognised by the Government of the People's Republic of Bangladesh
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:

1.2. DATE OF BIRTH

(on next birth date)


Years

1.2.1. AGE
D

M M

1.3. NATIONALITY

Acknowledgement:
Copies of Certificates
Copies of Transcripts

Photo Enclosed

1.2.2. PLACE OF BIRTH

AM

Professional Record Enclosed


Recommendation
Applied for

1.4. MAILING ADDRESS


(With postal code)

Name & Signature

Evaluated by Membership Section


Age

1.5. PERMANENT ADDRESS

(With postal code)

Education
Experience
Recommendation

1.6. PHONE

OFFICE

RESIDENCE

MOBILE
1.7.

GENDER

Name & Signature

E-mail
MALE

FEMALE

(please tick as )

Chairman/Member Secretary/Member,
Membership Committee

1.8. MEMBERSHIP APPLYING FOR

Accepted

1.9. PRESENT IEB MEMBERSHIP NUMBER (if


any)

Rejected

Name & Signature


F/M

2.0. EDUCATION (enclose attested photocopies of certificates)


EQUIVALENT
LEVEL

INSTITUTE

BAOARD/UNIVERSITY

YEAR OF
PASSING

DIV/CLASS
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
Sub-Division

Civil

Mechanical

Electrical

Chemical

Agricultural

Computer

Textile

4.0 PROFESSIONAL RECORD (If Necessary enclose separate page)


PERIOD(Date)

SL.
NO.

DESIGNATION
FROM

EMPLOYER

BRIEF JOB DESCRIPTION

TO

1
2
3
4
5
6
5.0 Please enclose attested copies of certificates of other professional bodies including Membership no.(if any)
1
2

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.

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
Countersigned by

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


held on .................................................................
Chairman

Membership Committee

Member Secretary

8.0 INFORMATION FOR APPLYING FOR MEMBERSHIP OF THE IEB


Subscription Rate
Category

Others

Entrance
Fee(Tk.)

Annual
Subscription(Tk.)

Diploma
Fee(Tk.)

Total
(Tk.)

Age in
years (At least)

Experience(Minimum)

Fellow

400.00

600.00

100.00

1,100.00

35

10 years
15 years(if Non Member)

Member

200.00

350.00

100.00

650.00

25

3 years (in Non Member)


2 years (if Associate Member)

Associate
Member

125.00

175.00

50.00

350.00

Pl. Enclose attested copies

1.Photo PP Size (2copies)


2.Certificate: SSC, HSC, BSc. in Engg.

B. Sc. Engg.
Or Equivalent

3.Transcripts: HSC/Diploma. Engg.


4.Certificates of other Professional Bodies(if any)