Please read carefully and complete in detail form 1/DA



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PLEASE READ CAREFULLY AND COMPLETE IN DETAIL FORM 1/DA






APPLICATION FOR ADMISSION IN AN ADDITIONAL DISCIPLINE BY RECIPROCAL RECOGNITION

For use by HKIE Corporate Members with a relevant, recognised professional qualification in the discipline being applied for.

(One Form to be completed for each Discipline)
Applicant to complete Sections A, B and C.

Supporter to complete 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

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

Present membership number













Present Discipline/s













Applying for admission by reciprocal recognition in the Discipline.







  1. I declare that I am currently competent to practise in the _______________________Discipline, for which I am applying, and that the statements on this form are correct.




  1. In support of my declaration, I attach herewith a photocopy of the certificate of my Corporate Membership of ___

(photocopy of the certificate must be produced and endorsed by the Supporter as a true copy.)

* e.g. MICE to support application for recognition in the Civil Discipline, MIGEM for Gas Discipline etc.





Signature of applicant

Date


6/2015

This form needs to be completed and returned together with the Application Fee required.

(Details please refer to fee list)

Section C Professional experience in details.


Please give dates, posts held and exact nature of duties (Applicant may consider providing a verified copy of curriculum vitae for convenience).








Verifying Initial of Supporter

























































































































Section D Attestation by Supporter
I, the undersigned, support the Applicant from personal knowledge, as a person worthy of consideration for admission in the said Discipline by reciprocal recognition, and I endorse the correctness of those parts of Section C which I have identified by my initial. (See footnote)

Initial









Full Name (in block letters)







FHKIE/MHKIE Membership No.




Signature



N.B. The applicant MUST be supported by one Corporate Member of the HKIE who must be in the same Discipline which the applicant applies for.



For Applicants from Hong Kong Computer Society (HKCS) under the Reciprocal Recognition Agreement between the HKIE and HKCS.

Support from HKCS for this application: __________________________.

(Authorized Signature)

HKCS




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


App. Recd:




Q & M Decn:




Applicant Adv:







Pres. Class:




Disc. Appd:




D.M’ship from:





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