2016 IEEE MEMBERSHIP APPLICATION
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Attestation
I have graduated from a three- to five-year academic program with a university-level degree.
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This program is in one of the following fields of study:
■Engineering
■ Computer Sciences and Information Technologies
■ Physical Sciences
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■Mathematics
■ Technical Communications, Education, Management, Law and Policy
■ Other (please specify): _________________
This academic institution or program is accredited in the country where the institution
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I have ______ years of professional experience in teaching, creating, developing,
practicing, or managing within the following field:
■Engineering
■ Computer Sciences and Information Technologies
■ Physical Sciences
■ Biological and Medical Sciences
■Mathematics
■ Technical Communications, Education, Management, Law and Policy
■ Other (please specify): _________________
▼
B.Principal job function
State/Province
1.
2.
3.
4.
5.
6.
7.
8.
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First/Given Name
Date of birth (Day/Month/Year)
1. Computers
2. Computer peripheral equipment
3. Software
4. Office and business machines
5. Test, measurement and instrumentation equipment
6. Communications systems and equipment
7. Navigation and guidance systems and equipment
8. Consumer electronics/appliances
9. Industrial equipment, controls and systems
10. ICs and microprocessors
11. Semiconductors, components, sub-assemblies, materials and supplies
12. Aircraft, missiles, space and ground support equipment
13. Oceanography and support equipment
14. Medical electronic equipment
15. OEM incorporating electronics in their end product (not elsewhere classified)
16. Independent and university research, test and design laboratories and
consultants (not connected with a mfg. co.)
17. Government agencies and armed forces
18. Companies using and/or incorporating any electronic products in their
manufacturing, processing, research or development activities
19. Telecommunications services, telephone (including cellular)
20. Broadcast services (TV, cable, radio)
21. Transportation services (airline, railroad, etc.)
22. Computer and communications and data processing services
23. Power production, generation, transmission and distribution
24. Other commercial users of electrical, electronic equipment and services
(not elsewhere classified)
25. Distributor (reseller, wholesaler, retailer)
26. University, college/other educational institutions, libraries
27.Retired
28.Other__________________________
General and corporate management
Engineering management
Project engineering management
Research and development
management
Design engineering management
—analog
Design engineering management
—digital
Research and development
engineering
Design/development engineering
—analog
9. Design/development
engineering—digital
10. Hardware engineering
11. Software design/development
12. Computer science
13.Science/physics/mathematics
14. Engineering (not elsewhere
specified)
15.Marketing/sales/purchasing
16.Consulting
17.Education/teaching
18.Retired
19.Other
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■ Female
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Engineering and scientific management
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Engineering design
Engineering
Software: science/mngmnt/engineering
6.
7.
8.
9.
Education/teaching
Consulting
Retired
Other
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7.
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9.
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Title
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1 PERSONAL
■ Male
3
Chairman of the Board/President/CEO
Owner/Partner
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VP Operations
VP Engineering/Dir. Engineering
Chief Engineer/Chief Scientist
Engineering Management
Scientific Management
Member of Technical Staff
10. Design Engineering Manager
11. Design Engineer
12. Hardware Engineer
13. Software Engineer
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16.Consultant
17.Retired
18.Other
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6
Add IEEE Society Memberships (Optional)
The 39 IEEE Societies support your technical and professional interests.
Many society memberships include a personal subscription to the core journal,
magazine, or newsletter of that society. For a complete list of everything
included with your IEEE Society membership, visit www.ieee.org/join.
All prices are quoted in US dollars.
BETWEEN
BETWEEN
16 AUG 2015- 1 MAR 201628 FEB 2016 15 AUG 2016
PAY
PAY
Please check ✔ the appropriate box.
IEEE Aerospace and Electronic Systems z y AES01025.00 ■
12.50 ■
IEEE Antennas and Propagation z y AP00315.00 ■
7.50 ■
IEEE Broadcast Technology § z y BT00215.00 ■
7.50 ■
IEEE Circuits and Systems § z y CAS00422.00 ■
11.00 ■
IEEE Communications z y
C0M019
30.00 ■
15.00 ■
IEEE Components, Packaging, & Manu. Tech. § z y CPMT021
2016 IEEE Membership Rates
(student rates available online)
IEEE member dues and regional assessments are based on where
you live and when you apply. Membership is based on the calendar
year from 1 January through 31 December. All prices are quoted
in US dollars.
Please check ✔ the appropriate box.
BETWEEN
1 MAR 201615 AUG 2016
PAY
BETWEEN
16 AUG 201528 FEB 2016
PAY
RESIDENCE
United States..................................................................$197.00 ■ .............. $98.50 ■
Canada (GST)*..............................................................$173.35 ■............... $86.68 ■
Canada (NB, NF and ON HST)*............................$185.11 ■............... $92.56 ■
Canada (Nova Scotia HST)*....................................$188.05 ■............... $94.03 ■
Canada (PEI HST)*......................................................$186.58 ■............... $93.29 ■
Canada (GST and QST Quebec)...........................$188.01 ■............... $94.01 ■
Africa, Europe, Middle East.......................................$160.00 ■............... $80.00 ■
Latin America..................................................................$151.00 ■............... $75.50 ■
Asia, Pacific......................................................................$152.00 ■............... $76.00 ■
15.00 ■
7.50 ■
IEEE Computational Intelligence z y CIS01129.00 ■
14.50 ■
IEEE Computer § z y C01656.00 ■
28.00 ■
IEEE Consumer Electronics z y CE008
20.00 ■
10.00 ■
IEEE Control Systems z y CS023
25.00 ■
12.50 ■
IEEE Dielectrics and Electrical Insulation z y DEI03226.00 ■
13.00 ■
IEEE Education z y E02520.00 ■
10.00 ■
IEEE Electromagnetic Compatibility § z y EMC02731.00 ■
15.50 ■
IEEE Electron Devices § z y ED01518.00 ■
9.00 ■
EMB01840.00 ■
20.00 ■
IEEE Geoscience and Remote Sensing z y GRS02919.00 ■
9.50 ■
IEEE Industrial Electronics z y IE0139.00 ■
4.50 ■
IEEE Industry Applications z y IA03420.00 ■
10.00 ■
IEEE Information Theory § z y IT01230.00 ■
15.00 ■
IEEE Instrumentation and Measurement z y IM00929.00 ■
14.50 ■
IEEE Intelligent Transportation Systems § z y ITSS03835.00 ■
17.50 ■
IEEE Magnetics § y tz MAG03326.00 ■
13.00 ■
IEEE Microwave Theory and Techniques z y MTT01717.00 ■
8.50 ■
IEEE Nuclear and Plasma Sciences § z y NPS00535.00 ■
17.50 ■
IEEE Oceanic Engineering § z y OE02219.00 ■
9.50 ■
IEEE Photonics § z y PHO03634.00 ■
17.00 ■
IEEE Power Electronics z y PEL03525.00 ■
12.50 ■
IEEE Power & Energy § z y PE03135.00 ■
17.50 ■
IEEE Product Safety Engineering §
PSE04335.00 ■
17.50 ■
IEEE Professional Communication § z y PC02631.00 ■
15.50 ■
Canadian residents pay 5% GST or appropriate HST (BC—12%; NB, NF,
ON-13%;NS-15%) on Society payments & publications only......................TAX
IEEE Reliability § z y RL00735.00 ■
17.50 ■
IEEE Robotics and Automation z y AMOUNT PAID................................................................................. TOTAL $________
RA0249.00 ■
4.50 ■
IEEE Signal Processing § z y SP00122.00 ■
11.00 ■
IEEE Social Implications of Technology § z y SIT03033.00 ■
16.50 ■
IEEE Solid-State Circuits z y SSC03722.00 ■
11.00 ■
IEEE Systems, Man, & Cybernetics z y SMC02812.00 ■
6.00 ■
IEEE Technology & Engineering Management z y TEM01435.00 ■
17.50 ■
IEEE Ultrasonics, Ferroelectrics, & Frequency Control § z y UFFC02020.00 ■
10.00 ■
IEEE Vehicular Technology § z y 9.00 ■
IEEE Engineering in Medicine and Biology z y
VT00618.00 ■
Legend—Society membership includes:
y
Online access to publication
z
One or more Society publications
t
CD-ROM of selected society
§Society newsletter
publications
*IEEE Canada Business No. 125634188
Minimum Income or Unemployed Provision
Applicants who certify that their prior year income did not exceed US$14,700
(or equivalent) or were not employed are granted 50% reduction in: full-year dues,
regional assessment and fees for one IEEE Membership plus one Society Membership.
If applicable, please check appropriate box and adjust payment accordingly. Student
members are not eligible.
■ I certify I earned less than US$14,700 in 2015
■ I certify that I was unemployed in 2015
More Recommended Options
7
Proceedings of the IEEE.................... print $47.00 ■ or online $41.00
Proceedings of the IEEE (print/online combination) ...................$57.00
IEEE Standards Association (IEEE-SA).................................................$53.00
IEEE Women in Engineering (WIE)......................................................$25.00
■
■
■
■
Payment Amount
8
Please total the Membership dues, Society dues, and other amounts
from this page:
IEEE Membership dues 6 .............................................................. $_______
IEEE Society dues (optional) 5 .................................................. $_______
IEEE-SA/WIE dues (optional) 7 ................................................... $_______
Proceedings of the IEEE (optional) 7 ........................................ $_______
$________
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CAMPAIGN CODE
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PROMO CODE
15-MEM-385 P 6/15
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