Application for election or transfer to the class of fellow



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PLEASE READ CAREFULLY AND COMPLETE IN DETAIL FORM 1/F

APPLICATION FOR ELECTION OR TRANSFER

TO THE CLASS OF FELLOW

Applicant to complete Sections A, B, and C.

Supporters to provide specimen initials in Section D and to initial those parts of Section C which are appropriate.

Complete in block letters or type



Section A



Personal details

(Please indicate your name as shown on the H.K.I.D. Card or other identification documents)







Surname




Ir/Prof/Dr/Mr/Mrs/Miss

Female/Male



















Other Names




ID Card No






















Chinese Name (if applicable)




























Address for Communication



















Tel No.













Mobile






















Residential Address



















Tel No.













E-mail






















Company Name



















Tel No.







Position




Fax No.






















Date of Birth

Age




Place of Birth




Section B Obligation


1. I, the undersigned, agree that, in the event of my election or transfer to Fellowship in The Hong Kong Institution of Engineers, I will be governed by the Constitution of the Institution, as it now is, or as it may hereafter be amended. I agree to comply with the Rules of Conduct and advance the Objects of the Institution. I shall pay all subscriptions, as set by the Council from time to time, provided that whenever I shall signify my wish to resign, in writing, to the Secretary I shall, after the payment of any arrears which may be outstanding, be free from this obligation.

2. I have / have not* been convicted of a criminal offence# (#Please refer to the separate guideline attached to this application form).

3. Where I was previously a member of The Hong Kong Institution of Engineers, I confirm that no improper conduct (except that provided in Article 13(2) of the Constitution on non-payment of subscription) had been alleged against or committed by me while I was a member. I am also aware that any investigation or proceedings relating to any such improper conduct may be re-activated and/or continued against me by the Institution should I be re-admitted to membership. Accordingly I agree to provide to the Institution upon its request any particulars or information relating to any such improper conduct as it may require.

4. I declare that the above statements on this form are true and correct.





Signature of applicant Date
* PLEASE DELETE AS APPROPRIATE

FOR TRANSFER, PLEASE STATE YOUR PRESENT CLASS IN THE HKIE:_____________________________

6/2015
THIS FORM NEEDS TO BE COMPLETED & RETURNED TOGETHER WITH THE FEES REQUIRED. (Details please refer to fee list)

PRIVATE AND CONFIDENTIAL



Section C



  • If you are applying for transfer from the class of Member you need not complete Sub-Sections 1 and 2, and only experience subsequent to the date of admission as a Member should be noted in Sub-Section 3. If you are applying for transfer from any class except Member or for election, you must complete each Sub-Section.

  • Your entries in this section should be contained within the space provided.

  • Copies to be reduced to A4 size


Sub-Section 1

From

Mth/Yr


To

Mth/Yr


 Academic qualifications (Photocopies of documentary evidence must be produced and endorsed by at least one Supporter as a true copy).

Verifying Initials of Supporters











University and country


Award and date


Discipline / Subject studied






















































































































































Sub-Section 2

 Training


























































Sub-Section 3

 Professional Experience (Details required of experience and positions held during the past TEN years.) and a detailed CV. If there is insufficient space, please give details on separate sheets to be attached to this form.





















































































































































































































































































































Section C (Continued)


From

Mth/Yr


To

Mth/Yr



Professional Experience (continued)

Verifying Initials of Supporters
























































































































































































Discipline (Please indicate below in which Discipline you consider you are primarily qualified for professional practice, e.g. Aircraft, Biomedical, Building, Building Services, Chemical, Civil, Control, Automation & Instrumentation, Electrical, Electronics, Energy, Environmental, Fire, Gas, Geotechnical, Information, Logistics & Transportation, Manufacturing & Industrial, Marine & Naval Architecture, Materials, Mechanical or Structural)
Primary Discipline (one ONLY of the above)
I declare that I am competent to practise in the above discipline.
Applicant’s Signature________________________________________________





Date Qualified/Membership No.

(DD/MM/YY)



Contribution to the Institution, Professional Service, Papers Presented, etc.


































 Professional qualifications (Photocopies* of documentary evidence must be produced and endorsed by at least one Supporter as a true copy).































Organisational charts indicating in each position of responsibility (including the present position) the number of qualified engineers directly or indirectly under your supervision. Please give the charts and details on separate sheets to be attached to this form.


Verifying Initials___________________

(Supporter’s)

Applicant’s present post ______________________


__________________________________________
Employer__________________________________
__________________________________________
I declare that the statements in Section C are correct.

Applicant’s Signature_________________________
Date______________________________________






Section D

Attestation by Supporters



We, the undersigned, support the Applicant from personal knowledge, as a person worthy of consideration for election to the class of Fellow and we endorse the correctness of those parts of Section C which we have identified by our initials. (See footnote)

Initials





Supporter 1

Full Name (in block letters)































FHKIE/MHKIE Membership No.




Signature



Initials







Supporter 2

Full Name (in block letters)































FHKIE/MHKIE Membership No.




Signature



Initials







Supporter 3

Full Name (in block letters)































FHKIE/MHKIE Membership No.




Signature



Initials







Supporter 4

Full Name (in block letters)































FHKIE/MHKIE Membership No.




Signature




N. B. Applicant for election to Fellowship MUST be supported by four Corporate members of the HKIE, two of whom must be Fellows and two of the four, must be in the same discipline as the applicant.




According to the Agreement on Reciprocal Membership Promotion between the HKIE and ASME, members of ASME residing outside Hong Kong will receive a 50% discount off the annual subscription fee of the HKIE members as “Affiliates” or as “non-resident” members admitted through the HKIE’s system.
I declare that I am a member of ASME residing outside Hong Kong. (Membership No. __________________________)
Applicant’s Signature ______________________



FOR HKIE SECRETARIAT USE ONLY

Appen. Recd





Q & M Deen





Applicant Adv.





Pres. Class





App. by Council





Ent. or T. fee


$

Class App. for




Discipline/s





Subn.

$

Thru.Q & M





Division/s





Pd/M’ship from




























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