APPLICATION FOR ELECTION AS A MEMBER
(Please read the notes before completing this form)
Surname: / Title: / Date of Birth: / Proposer
OR
Seconder
Initials
(to confirm
information
given
is correct)
Forename(s):
Address for Correspondence: Phone Number:
Mobile:
Fax Number:
Postcode:
Email:
Higher Education (Year, College/ University, Exams Passed, and Grade):
Membership of Other Professional Institutions (Institution, Grade, Membership Number):
Present Occupation (Brief description of role, responsibilities, and experience including dates):
Name and Address of Current Employer (including Job Title):
Phone Number:
Fax Number:
Postcode:
Email:
Previous Employers or Occupations (including brief description of role, responsibilities, and experience including dates):
Relevant Engine or Gas Turbine Experience:
If User, give details of Plant Operated:
Please state how you heard of the Institution:
I wish to become a Member of the Institution of Diesel and Gas Turbine Engineers and agree that, in the event of my election, I shall observe the Rules of the Institution. I enclose payment for the registration fee and first year's subscription (subscription fee refundable if application unsuccessful) *.
Signature: / Date:
** Proposer’s Name: / ** Seconder’s Name:
Job Title: / Job Title:
Address: / Address:
Signature: / Signature:
Date: / Date:
OFFICE USE ONLY / President’s Signature:
Elected: / Date:
Registration Fee: / Date:
Amount £
Subscription received: / Date:
Amount £ / Membership Number: M

Please read these notes carefully before completing this form.

1. REGISTRATION FEES *

A fee of £25.54 is payable on submission of an application for Membership.

 Cheque enclosed for £ .

 Payment by credit/debit card (American Express not accepted) £ .

Card Number
Issue No (Switch/Solo) / Security Code / Expiry Date of Card

(last 3 digits on reverse of card)

2.ANNUAL SUBSCRIPTIONS 2011 *Members UK & Europe £92.00

Payable on election, and annually thereafter.Overseas £75.00

(£15.00 reduction in membership fee if you choose to receive the Power Engineer electronically)

3.WEB SITE

For further information about the Institution, please go to our web site

4. PROPOSER/SECONDER **

The proposer and seconder are confirming that the information provided is accurate and true. Ideally, at least one should be an existing IDGTE member, or member of another recognised professional body (if so please include membership number and Institution name).

5.APPLICATION GUIDE

It is recommended that applicants read the "Membership Application Guide" which gives guidance on completing this form. The guide is available on the website or from the IDGTE office.

Founded in 1913 as Diesel Engine Users Association

The Institution of Diesel and Gas Turbine Engineers, Bedford Heights, Manton Lane, Bedford MK41 7PH

Tel +44 (0)1234 214340 Fax +44 (0)1234 355493 Email: