Online "Patron" 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:

Patron Membership Criteria:

Is this Patron membership in your personal capacity or that of the Company:
Clearly state the name of the member or company:

Involvement in the field of engineering activity:
Briefly describe your or the companies involvement by giving the necessary detail below:

 

Employer of certificated engineers:
Briefly describe the number of, and duties of the certificated engineers employed:


Interest in the advancement of the electrical and/or mechanical engineering profession by encouraging the attainment of the certificate of competency.
Briefly describe the interest, or, role played in encouraging the attainment of the Certificate of Competency, by giving the necessary detail:

 

Rendering of an important service to electrical or mechanical engineering in commerce, finance, law, science, or education:
Briefly describe your role by giving the necessary detail:

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.