ICMEESA online membership application

"MEMBER" MEMBERSHIP APPLICATION

Please fill in and submit your details on the online application form below,

or, you may download a MS Word membership application form ?

NOTE: When entering your information into the form below, navigate to the next field using the "TAB" key or the mouse. Use of the "ENTER" key will result in the form being sent prematurely.

Online "Member" Application Form

Personal Information:

Initials:

First names:

Surname:

Title:

Date of Birth:

Contact Details:

Telephone Home:

Telephone Work:

Cellular:

Fax:

Email Home:

Email Work:

Primary Postal Address: (the preferred address for correspondence. Home or work)

Postal Code:

Secondary Postal Address:

Postal Code:

Certificates of Competency

Mines Electrical: Cert No: Date of Issue:

Mines Mechanical: Cert No: Date of Issue:

Factories Electrical; Cert No: Date of Issue:

Factories Mechanical: Cert No: Date of Issue:

ECSA registration:

Category: Reg No:

Declaration:

In submitting this application I declare that the particulars given in this application are correct and that I agree, that in the event of my admission to the Institution, I will be governed by the Constitution and By Laws of The Institution of Certificated Mechanical and Electrical Engineers, South Africa, as they are now formulated or as they may be hereafter altered. I will advance the objects of the Institution as far as shall be in my power and will so order my conduct to uphold the dignity of the profession of the Engineer, act ethically and uphold the established traditions of the Institution.