Fellow-Appl-Br-or-Div.doc

Fellow-Appl-Br-or-Div.doc - THE SOUTH AFRICAN INSTITUTION...

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THE SOUTH AFRICAN INSTITUTION OF CIVIL ENGINEERING RECOMMENDATION BY A BRANCH OR DIVISION COMMITTEE FOR THE ELECTION OF A CORPORATE MEMBER TO THE GRADE OF FELLOW Private Bag X 200 Tel: (011) 805 5947/8 Halfway House Fax: (011) 805 5971 1685 E-Mail: [email protected] Notes: - Please use black ink and block letters. - Hierdie vorm is in Afrikaans verkrygbaar. - A brief motivation of not more than 100 words by the proposer needs to be included with the nomination. NOMINATING BRANCH/DIVISION: ______________________________ A NOMINEE Surname: First names: Title: Address: Code: Date of birth: I.D. No: Home Language: Citizenship: Employer: Present Position: Employer’s Address: Code: Date of election as a Member (if known): Professional Registration with ECSA: Pr Eng / Pr Tech (Eng)* Registration Number: __________ Tel No. (H): Tel No. (W): Fax No.: E-Mail: Correspondence Preference: I, hereby accept nomination for election to the grade of Fellow and agree to be transferred to the grade if elected by the Executive Board of SAICE. Signature: Date: A E For Office use only Number: Age: MOI: Exp:
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B CONFIRMATION OF
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  • Fall '14
  • Civil Engineering, executive board, AFRICAN INSTITUTION OF CIVIL ENGINEERING, SAICE

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