AUTHORISATION OF PAYMENT BY CREDIT / DEBIT CARD

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Domenic Turner
5 years ago
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1 You can also pay the due amount by Credit / Debit Card AUTHORISATION OF PAYMENT BY CREDIT / DEBIT CARD AUTHORISATION *Credit / Debit Card [Tick as applicable] MASTERS VISA Please charge Rs.... against Card No. Card Expiry Date M M Y Y Y Y Card Holder s Signature... Card Holder s Name... Applicant s Name... Membership Grade &... No. [If applicable]

2 (ESTABLISHED 1920, INCORPORATED BY ROYAL CHARTER 1935) Phone : (91) (033) , 8314, 8315, Fax : (91) (033) , & membership@ieindia.org. PRIVILEGES OF INSTITUTIONAL MEMBERS 1. Institutional Members will receive all parts of Journal and other Publications per year giving the latest knowledge as applicable to 15 Engineering Disciplines; 2. Five Library Cards of IEI libraries without payment of any fees, (Security deposit however, is applicable); 3. IEI Accreditation of any two engineering courses as per IEI system of accreditation on your application without any accreditation fee; 4. Participation of two representatives of Institutional Member in International activities organised by IEI across the country at a concession of 50% in Registration fee. 5. Concessional rates for advertisement in the Institution Publication provided these are sent directly to the Institution, 6. Use of Institution Premises for Technical / Academic purpose on payment of fee to be fixed by the State / Local Centre; 7. Facility of IEI guest room accommodation to Managerial / Technical Staff at rates fixed by the State / Local Centre; 8. Invitations to IEI National Seminars / Symposia throughout India; 9. Technical advice as and when necessary on mutual consent; 10. Participation of Deputed Staff (both Engineering and Managerial) in Seminars/Symposia at the concessional rate offered to regular Members.

3 Payment advice CF III For payment by Demand Draft only The Institution of Engineers ( India) TO BE FILLED IN BY THE APPLICANT I enclose a Demand Draft No.... Dated... for Rs.... Drawn on (Name of the Bank and its Branch) for Office use only Regn. No.... CC C. No In respect of the following : 1. Application Deposit (Life IM) 06 Rs.... Name (in block letters) Full Address Pin Code Date 200 The Institution of Engineers ( India) Name Full Address Pin Code Acknowledgement-cum-Receipt (for Office use only) Signature with official seal Receipt No.... Application Registration No.... Date... Received with thanks a sum of Rs... (Rupees ) from the above named/institute/applicant/company/firm towards the Application Deposit. for Secretary & Director General

4 APPLICATION FOR LIFE INSTITUTIONAL MEMBERSHIP for office use only Application Deposit Rs.... Recd. on... Sign... Application Regn. No.... Regd. on... Membership No.... Enrolled... Acknowledged on... Signature... The applicant fulfils the conditions of Bye-laws. The application may be approved for Life Institutional Member. Adjustment of Rs.... for Secretary & D. G. I/We desire to be attached as Life Institutional Member of the Institution of Engineers (India), in accordance with the Charter of Incorporation and the Bye-laws as they now stand or as they may hereafter be legally altered. Name and designation of signing Officer (With Official Seal) Date 200 Name of the Organisation / Person To be recorded : Full Postal Address Pin Code LIFE COMPOUNDING FEE RS. 1,00,000 (ONE LAKH ONLY) IS ENCLOSED BY DRAFT No... dated... on... payable to THE INSTITUTION OF ENGINEERS (INDIA), KOLKATA NOTE : PAYMENT BY DEMAND DRAFT ONLY ON ANY BANK AT KOLKATA WILL BE ACCEPTED. PAYMENT BY OUTSTATION CHEQUES / DRAFTS WILL NOT BE ACCEPTED.

5 (ESTABLISHED 1920, INCORPORATED BY ROYAL CHARTER 1935) GRAM : ENJOIND, KOLKATA FAX : (91) (033) PHONE : , 8314, 8315, 8316, 8333, GOKHALE ROAD, KOLKATA finance@ieinida.org. Ref. : FN/ Registered/Courier/Ordinary Date Dear Sir/Madam Enclosed please find a Cheque / Draft No. Dated on UTI/Bank of Baroda / Syndicate Bank payable at per all Branches for Rs. Against Payment of Note This letter may please be retained for Income Tax purpose. Yours faithfully, For Secretary & Director General (Form of receipt to be filled in and returned to The Institution of Engineers (India) Kolkata for audit purpose) Received from The Institution of Engineers (India) a sum of Rs. vide Cheque / Draft No. Date Being Revenue Stamp (Name in Block letter) Signature

Remaining Name. IFSC No. : IBKL Bank Name & Branch : IDBI Bank, Siddha Point, Ground Floor, 101 Park Street, Kolkata

Remaining Name. IFSC No. : IBKL Bank Name & Branch : IDBI Bank, Siddha Point, Ground Floor, 101 Park Street, Kolkata The Institution of Engineers ( India) An ISO 9001:2008 Certified Organisation 8 GOKHALE ROAD, KOLKATA 700 020 Application for Associate Membership Technologiest (AMTIE) AMT For Office Use only Name : Last