THE CHAMBER OF ENGINEERING TECHNOLOGY
(Association Not For Gain)
2009
P.O. Box 1269 Tel / Fax / Answering Unit 011 787 1302
Ferndale
2160 E Mail engineer@netactive.co.za
Application for Membership / Aansoek om Lidmaatskap
1. General Information / Algemene Inligting
Home Language/ Huistaal ________________________________________________
Surname / Last name / Van ________________________________________________
First Names / Voorname ________________________________________________
Date of Birth / Geboortedatum ______________________________________________
ID number / ID Nommer ______________________________________________
Postal Address _________________________________________________
_________________________________________________
_________________________________________________
Postal Code / Poskode __________________________________________________
Fax / Faks ___________________________________________________________
E Mail /E Pos
Alternate Tel / Fax numbers
2. Engineering Informatiom / Ingenieurswese Inligting
Engineering Council of SA (ECSA) Registration Number
SA Raad vir Ingenieurswese (ECSA) Registrasie Nommer
_________________________________________________
Branch of Engineering / Tak van Ingenieurswese
(Mechanical, Electrical, Civil etc / Meganies, Elektries, Siviel ens) ________________________________________________________________________
Engineering Qualification / Ingenieurswese Kwalifikasie
________________________________________________________________________
3. Declaration
I hereby apply for membership of The Chamber of Engineering Technology and undertake
to abide by all the provisions of the Constitution and the Code of Conduct of the
Engineering Council of South Africa (ECSA). / Hiermee doen ek aansoek om lidmaatskap van
Die Kamer van Inginieurswesetegnolgie en onderneem om aan alle vereistes van die Grondwet,
Reglemente en die Gedragskode van die SA Raad vir Ingenieurswese (ECSA) te voldoen.
Print Name / Naam 'n drukskryf
___________________________________________________________________________
Signature / Handtekening
___________________________________________________________________________
Date / Datum ______________________________________________________
4. Application Fee / Aansoekfooi R 50,00
Annual Fee / Jaarlikse Ledegeld R 292,00
Total R342-00
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We require originals.
