SAFETY ENGINEERS ASSOCIATION

SEA – (India)

(Registered under Societies Act – 1975)

Tel: 044 23774060/9952005534/

7358578115 /9884514060

E Mail:

URL: “

Address: Safety Engineers Association G1, Vinoth Foundation,95/5, Sundaramurthy Gramani Street (Near ChandraMetromall, Inox National Theatre) Virugambakkam, Chennai-600092

Membership Application Form
I hereby apply for the Membership of the Safety Engineers Association SEA (India) in a grade appropriate to my qualification and experience. All required copies of documents are enclosed: / Affix Photo
1.Name :
(in CAPITAL letters) / Father's
/Husband Name :
2.Date of Birth: / Age: / Sex: M/F
3.Address for Correspondence: / Mob. No. :
E-Mail (personal)::
5.(a).Educational Qualification:
Degree/Diploma/Certificate / Subject / Awarding Institute / Year
(Please attach copies of relevant certificates of educational qualifications)
5.(b) Membership from other professional institution/s:
Name of Membership (Field/Area) / National /International / Awarding Institute / Year
6.Career / Experience Details:
Sl.no. / From (Date) / To (Date) / Organisation's Name & Address / Position
i
ii
iii
7. Paymentcan be made by Cheque / DD or through NEFT Transfer. (as per details given). Amount Paid Rs: / Cheque / DD No:
Bank / Date
8.Declaration:To the best of my knowledge and belief, the above particulars are correct. In the event of my being enrolled as a member, I will abide by the Bye-Laws of the Association.
Place:
Date: / Applicant's Signature

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Guidelines for filling up the application:

  1. Please attach copies of certificates and passport size photo.
  1. Also attach copies of Experience certificates and details particularly in the field of Safety.
  1. Enclose Cheque / DD for the amount mentioned below in favour of “Safety Engineers Association”, payable at ‘Chennai’.
  1. Payments can be made through NEFT Transfer and all details of transfer including the bank and branch from where transferred and transaction number etc be communicated to SEA Office through Email.()
  1. Appropriate membership (as Life Member/ Life Associate Member / Life Affiliate Member) will be approved by the Executive Committee based on the applicant’s qualifications and experience. On approval, a Welcome Kit will be forwarded to the new members.
  1. Students undergoing Safety & Health courses at recognized Universities / Institutes should forward their application for ‘Student Member’ along with a Bonafide Certificate from their College / Institute and Cheque / DD towards their Annual Fees and Registration Fees.

Bank Details for NEFT Transfer:

Bank Name / HDFC BANK
Account Name / Safety Engineers Association
Branch Name / Valasaravakkam
A/c No. / 50100082953398
A/C Type / SB
MICR No (9 Digit) : / 600240005
IFSC Code No. / HDFC0000024

MEMBERSHIP FEES:

Grades / Registration Fee / Annual Fees / Life Membership Fee
Corporate
1. Fellow Rs. 100 /- NA Rs. 15000
2. Member / Rs. 100 /- / NA / Rs. 6000
Non – Corporate
1. Associate Member / Rs. 100 /- / NA / Rs. 6000
2. Affiliate Member / Rs. 100 /- / NA / Rs. 6000
3. Student Member / Rs. 100 /- / Rs. 500+Applicable GST / NA

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