The Institution of Electronics and Telecommunication Engineers
Application Form for IETE Student
Forum Membership (ISF)
Phone : +91 (11) 5150451/ 24631810 /20 /30 /40 /50
Fax : +91 (11)24631810 / 24649429
e-mail : ietend@giasdl01.vsnl.net.in
membership@iete.org
Website : www.ietepune.org www.iete.info
The Secretary General ,
IETE ,
2 , Institutional Area ,
New Delhi –110 003
Lodi Road ,
Dear Sir
I _________________________________________________son / daughter
( Name in Capital Letters)
Of ______________________________born on _______________________
and a sudent pf BE Or Diploma ___________________is desirous of becoming
a member of the IETE Student’s Forums to be started at ________________
______________________________________________________________
(college)
My mailing Address is ____________________________________________
_____________________________________________________________
Phone _____________Fax____________E-mail______________________
A DD in Favour of IETE ,New Delhi toward subscription as (i) Student (FG)
for Rs.400/-( max life 4 year );() Student (FD) for Rs.300 /-(max.life 3 year )along
with recent passport Size Photograph is sent herewith.
*student(s) Studying in :
Engineering College
1st year
2nd year
3 rd year
4th year
Rs.400 /Rs.300 /Rs.300 /Rs.100 /-
Polytechnic
Rs.300 /Rs.200 /Rs.100 /-
Signature __________
Date ______________
( Endorsement by the principle or the head of the
College/ institution where the student is studying)
I certify that Shri ______________________________Is a bonafide student of
__________year of the BE/ BTech. Degree/ Diploma in Electronics And
Telecommunication /computer/Electrical Engineering, and the information given
above is correct as per the college record.
Place _______
Date ________
Signature_____________
Name ________________
Office Stamp
IETE Membership No.___________