STUDENT MEMBERSHIP PACKAGE
Computer Society Digital Library (CSDL) included
with your IEEE Computer Society membership.
ELIGIBILITY
Student members must carry at least 50% of a full-time graduate or undergraduate academic
program. Current IEEE student members can join Computer Society for US $8.00 and receive access
to the Computer Society Digital Library.
Students must apply for membership prior to graduation in 2016.
SCHEDULE OF DUES
Membership is annualized to and expires on 31 December 2016. Pay full or half-year rate depending
on the date of receipt by IEEE Computer Society as illustrated below.
Prices expire on 15 August 2016.
MEMBERSHIP OPTIONS
All prices are in U.S. dollars
FULL YEAR
HALF YEAR
Applications received
16 Aug 2015 – 29 Feb 2016
Applications received
1 Mar 2016 – 15 Aug 2016
Join both IEEE and IEEE Computer
Society, plus get access to the CSDL
U.S. AND CANADA
$40.00
$20.00
REST OF THE WORLD
$35.00
$17.50
I already belong to IEEE and want to
join Computer Society, plus get access
to the CSDL
$8.00
$4.00
Student members also receive Computer magazine as a Digital Edition (print version is an additional fee).
JOIN IEEE COMPUTER SOCIETY TODAY!
Complete the back of this form, or apply for membership online at www.computer.org/join
When applying online, please be sure to have your educational information and credit card
readily available.
Mail or fax your completed form to:
IEEE Computer Society
445 Hoes Lane
Piscataway, NJ 08854-4141 USA
Phone: +1 732-981-0060
Fax: +1-732-562-6380
Join online at www.computer.org/join
IEEE Computer Society: Student Membership Application
Start your membership immediately: Join online www.computer.org/join
Complete this form, by typing or printing in capital letters. Use only English characters
and abbreviate only if using more than 40 character and spaces per line. Incomplete applications cannot be processed.
PERSONAL INFORMATION
EDUCATION INFORMATION
Please PRINT your name, as you want it to appear on your membership card and
correspondence. As a key identifier, circle your last/surname.
Please complete school/name information. No abbreviations please. This
information is required to qualify for student membership.
Male Female Date of Birth (Day/Month/Year)_________________
UNIVERSITY
TITLE
FIRST/GIVEN NAME
MIDDLE
LAST/SURNAME
▼ ADDRESS DURING ACADEMIC YEAR
SCHOOL OR COLLEGE (if applicable)CAMPUS
STREET ADDRESS
STREET ADDRESS
CITY
STATE/PROVINCE
POSTAL CODE
COUNTRY
PHONEFAX
EMAIL
CITY
STATE/PROVINCE
POSTAL CODE
COUNTRY
DEGREE TITLE EXPECTED
EXPECTED GRADUATION DATE MO/YR
▼ CURRENT DEGREE PROGRAM (Check one)
▼ FAMILY/HOME ADDRESS
UNDERGRADUATE:
GRADUATE:
STREET ADDRESS
2 or 3 year
Masters
4 or 5 year
Ph.D.
▼ DO YOU HOLD OTHER DEGREES?
Yes (Complete Below)
No
CITY
STATE/PROVINCE
POSTAL CODE
COUNTRY
HIGHEST TECHNICAL DEGREE RECEIVED
EMAIL
PROGRAM MAJOR/COURSE STUDY
PHONEFAX
MO/YR RECEIVED
AREA OF CONCENTRATION
SEND ALL IEEE MAIL TO:
Address During Academic Year
Which of the following best describes the area of your degree? Please check one:
Family/Home Address
Engineering
Computer Sciences and Information
Technologies
Physical Sciences
Biological and Medical Sciences
To better serve our members and supplement member dues, your postal mailing
address is made available to carefully selected organizations to provide you with
information on technical services, continuing education and conferences. IEEE
does NOT rent out your e-mail address.
Please check this box if you do NOT want to receive these postal mailings.
Are you now or were you ever a member of IEEE?
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Yes
No
Mathematics
Technical Communications,
Education, Management, Law and Policy
Other (please specify):
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FULL UNIVERSITY NAME, CAMPUS AND PREVIOUS NAME IF APPLICABLE
CITY
STATE/PROVINCE
POSTAL CODE
COUNTRY
ADDITIONAL DEGREES HELD MO/YR RECEIVED
PROGRAM MAJOR/COURSE STUDY AREA OF CONCENTRATION
MEMBERSHIP NUMBER
WERE YOU REFERRED TO IEEE?
Yes No If yes, provide the following:
FULL UNIVERSITY NAME, CAMPUS AND PREVIOUS NAME IF APPLICABLE
MEMBER RECRUITER NAME
IEEE RECRUITER’S MEMBER NUMBER (required)
ATTESTATION
I attest that:
I am currently a registered undergraduate student at the university level
I am currently a registered graduate student and have graduated from a three to
five year academic program at the university level
My undergraduate program falls within:
Engineering
Computer Sciences and Information
Technologies
Physical Sciences
Biological and Medical Sciences
Mathematics
Technical Communications,
Education, Management, Law and Policy
Other (please specify):
�������������������������������������
My undergraduate program is accredited in the country where
Yes
No
Do Not know
the institution is located.
I am taking at least 50% of a full-time academic program or course
Yes
No
of study in an IEEE designated field of interest.
CITY
STATE/PROVINCE
POSTAL CODE
COUNTRY
PAYMENT AMOUNT (See other side for dues)
PAYMENT METHOD
All prices are quoted in US dollars. You may pay for IEEE membership by credit
card (see below), check or money order payable to IEEE, drawn on a U.S. bank.
Canadian residents pay 5% GST or 13% HST..................................TAX $�����������
AMOUNT PAID.............................................................................. TOTAL $�����������
Check
Visa
MasterCard
Discover
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Diners Club
Credit Card Number����������������������������������������������������������
Expiration Date (Month/Year)____________ Cardholder’s 5-Digit Zipcode��������������
(Billing Statement Address USA Only)
NAME AS IT APPEARS ON CARD
SIGNATURE