THE INSTITUTION OF ENGINEERS (INDIA)

The Institution of Engineers (India)

APPLICATION FOR NON-RECEIPT OF EXTENSION FOR
EXAMINATION REGISTRATION FORM

The Director(EEA)
The Institution of Engineers(India)
8 Gokhale Road
Kolkata 700 020

Dear Sir,
I have not yet received the Extension for Examination Registration Application Form with Format of Identity card for(√ mark as applicable).Section ASection BKindly arrange to send me the same.However,I enclose a demand draft of Rs 600/-(US$ 60 for overseas candidates)towards fee for two-year extension for examination registration.My address recorded with the Institution (√ mark as applicable).has been changedhas not been changed Format of change of address with draft of Rs 125/-(US$ 10 for overseas candidates)is also enclosed with the application.My particulars are given below:

NAME IN FULL :
RECORDED HOME :
STREET :
CITY :

PIN :

Mobile

Phone

E-MAIL :

MEMBERSHIP NO.:

APPLICATION FOR NON-RECEIPT OF EXTENSION FOREXAMINATION REGISTRATION FORM

APPLICATION FOR NON-RECEIPT OF EXTENSION FOR
EXAMINATION REGISTRATION FORM