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    Uipe Membership Application Form

    Uploaded by

    johnpatrickecodu
    The document is an application form for membership in the Uganda Institution of Professional Engineers. It requests information such as the applicant's name, date of birth, nationality, academic qualifications, engineering discipline, place of work, and contact details. It asks the applicant to select the class of membership they are applying for and sign a statement agreeing to be governed by the institution's constitution if admitted. It also requires a proposer and seconder who are both members of the institution in the same engineering discipline as the applicant. For student applicants, it needs approval from their university or technical college with details of their program.

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    © All Rights Reserved
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    Uipe Membership Application Form

    Uploaded by

    johnpatrickecodu
    44 views4 pages
    The document is an application form for membership in the Uganda Institution of Professional Engineers. It requests information such as the applicant's name, date of birth, nationality, academic qualifications, engineering discipline, place of work, and contact details. It asks the applicant to select the class of membership they are applying for and sign a statement agreeing to be governed by the institution's constitution if admitted. It also requires a proposer and seconder who are both members of the institution in the same engineering discipline as the applicant. For student applicants, it needs approval from their university or technical college with details of their program.

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    The document is an application form for membership in the Uganda Institution of Professional Engineers. It requests information such as the applicant's name, date of birth, nationality, academic qualifications, engineering discipline, place of work, and contact details. It asks the applicant to select the class of membership they are applying for and sign a statement agreeing to be governed by the institution's constitution if admitted. It also requires a proposer and seconder who are both members of the institution in the same engineering discipline as the applicant. For student applicants, it needs approval from their university or technical college with details of their program.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    44 views4 pages

    Uipe Membership Application Form

    Uploaded by

    johnpatrickecodu
    The document is an application form for membership in the Uganda Institution of Professional Engineers. It requests information such as the applicant's name, date of birth, nationality, academic qualifications, engineering discipline, place of work, and contact details. It asks the applicant to select the class of membership they are applying for and sign a statement agreeing to be governed by the institution's constitution if admitted. It also requires a proposer and seconder who are both members of the institution in the same engineering discipline as the applicant. For student applicants, it needs approval from their university or technical college with details of their program.

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    THE UGANDA INSTITUTION OF PROFESSIONAL ENGINEERS

    APPLICATION FORM FOR MEMBERSHIP

    Management Support Unit Building,

    Public Works Training Centre,


    Plot 2, Gloucester Avenue, Kyambogo
    P.O. Box 1308, KAMPALA
    Tel: 256-414-287292

    Email: membership@uipe.co.ug/ Website: www.uipe.co.ug

    Revised on……11th…………...Day of ………October……….…….2022


    APPLICATION FORM FOR MEMBERSHIP OR TRANSFER TO CLASS OF
    MEMBERSHIP

    PLEASE FILL THIS FROM IN TYPE WITH CAPITAL LETTERS DO NOT HAND WRITE

    1. GENERAL INFORMATION

    Name in full: Surname: …………….………. Middle Name: …………………...First Name:


    ……………………….

    Date of Birth (D/M/Y): ………………………………………………

    Nationality: ………………………… Gender ……………………….

    Academic Qualifications
    ………………………………………………………………………………………………………
    ………………………………………………………………………………………………………
    ………………………………………………………………………………………………………
    …………………………………………………………………………………
    Engineering Discipline……………………………………….…………………

    Place of work ……………………………………………………………………….

    Current Job Title……………………………

    City/Town name ……………………………………….

    Street Name ……………………………………………...

    Plot No. ………………………………………………….

    Tel: +256………………... Email: ……………………………………………………...

    UIPE Branch Membership: …………………………………...

    Application route for Membership (please tick) (Applicable for Members)

    £Projects £Academia £Mutual recognition (East Africa) £ Mutual Recognition


    (Commonwealth) £ Temporary Registration

    1
    Membership Class you are applying for (please tick only one):

    £Technician £Technologist £Student £Graduate £Member £Fellow £Honorary


    £Corporate (for companies only)

    2. OBLIGATION AND CERTIFICATION

    I, the undersigned, agree that in the event of my admission to the class of membership in the
    Uganda Institution of Professional Engineers, I will be governed by the constitution and bye-
    laws of the Institution, as they now are, or as they may hereafter be altered, and that I will
    advance the objectives of the Institution as far as shall be in my power, provided that whenever I
    shall signify in writing to the Honorary Secretary that I am desirous of withdrawing. I shall,
    after the payment of any arrears which may be due by the period, be free from this obligation. I
    certify that the statements given above are correct.

    Signature: Date:

    3. PROPOSER (Must be a Member of UIPE who is fully paid up and must be of the same
    discipline as the applicant). (This is not applicable for student member applicants)

    I, the undersigned, having read the form and report (where applicable) hereby propose/support
    the candidate from personal knowledge as a person worthy of admission in the class of
    membership applied for and I certify the correctness of the parts I have initialed. “I am fully
    aware that proposing an applicant without reading the reports will be considered unethical and
    bad professional conduct.

    Signed: Class of Membership:(Member or Fellow)

    Names in block letters

    Engineering Discipline……………………………………………………………………...

    Address for communication:

    Tel: .................................. Email: …………………………. Date…………………………

    2
    4. SECONDER (Must be a Member of UIPE who is fully paid up and must be same
    discipline as the applicant). (This is not applicable for student member applicants)

    I, the undersigned, having read the form and report (where applicable) hereby propose/support
    the candidate from personal knowledge as a person worthy of admission in the class of
    membership applied for and I certify the correctness of the parts I have initialed. “I am fully
    aware that proposing an applicant without reading the reports will be considered unethical and
    bad professional conduct.

    (Signed: Class of membership: :(Member or Fellow)

    Name in Block letters:

    Address for communication:

    Engineering Discipline…………………………………………………………………

    Tel…………………………… Email………………………… Date………………………

    5. APPROVAL BY THE UNIVERSITY OR TECHNICAL COLLEGE (for student


    members only)

    Name of University or Technical College………………………………………………...

    Department…………………………………………………………………………….

    Course being followed: ………………………………………………………………….

    Registration No: ………………………………………………………………………..

    Student No: …………………………………………………………………………….

    Year of Study (e.g. 1st 2nd, 3rd or 4th)………………………………………………………

    Expected year of Graduation …………………………………………………………

    Name of Dean or Head of Department: ……………………………………………….

    Signature……………… ……Date…………………………. Stamp………………………

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