The Institution of Civil Engineers (India)

Regd.: Office: Career House Bindra Complex, Model Town, Ludhiana (Punjab), Delhi office: Career House 4, East Park Road, (Near New Rohtak Road) Karol Bagh, New Delhi-110005 Email: info@ice.net.in Website: www.ice.net.in

Paste passport size photograph here. Do not pin or staple please. No attestation Please.

Signature of Candidate

Application Form for Qualifying Examination for ITI Holders

For office use only Exam centre allotted: ______________________ Roll No. : ________________________________ Date: ___________________________________ Remarks: _______________________________ Authorized Signatory ICE(I) Name of the Candidate Name of the Father/Husband Address
: : :

Total Amount received: _______________ DD No. ______________________________

State : Phone (with STD Code) Mobile Date of Birth Name of the Institutional member proposed to join Membership No. of the Institutional Member Educational Qualifications: Name of Examination Secondary/ 10th Standard Examination ITI or Equivalent Name of Board/University/Institution Year of Passing
: : : :

Pin :

Email :________________________ (DD-MM-YYYY)

City :

Subjects/Trade Passed

List of Enclosures: (Please Tick in column) S.No. 1 2 Name of Examination Secondary/ 10 Standard Examination ITI or Equivalent
th

Photocopy of Marksheet/ Certificate Attached

Details of the fee paid:

DD* No. _____________ dated ________ of Rs. 3500/- (Three Thousand Five Hundred Only) towards

Qualifying Examination fee.

*drawn in favour of The Institution of Civil Engineers (India) payable at Ludhiana (Punjab),

Date: ____________

Signature of the Candidate

Please note the following instructions carefully while filling the Examination Form.
1. This form will not be accepted after the expiry of the last date for receipt application form.

2. Form with incomplete/wrong information shall be rejected outright.

3. The Examination fee is neither refundable nor adjustable in any Examination /Account.

4. Candidates will seek Provisional enrolment within the prescribed dates in any Institutional Member (Students Chapter) and their enrolment will be regularized only after passing the Qualifying Examination and on receipt of their Enrolment & Examination fee and their being found eligible otherwise.

5. Syllabi for the Qualifying Examination can be downloaded from the website of the ICE (I). www.ice.net.in

6. The Syllabus for the Examination will consist of Applied Physics, Chemistry and Applied Mathematics as approved by the Academic Council of The Institution of Civil Engineers (India).

7. It will be an Objective type Examination.

8. Result of the qualifying examination will be notified within 7 days from the date of examination.

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