APPLICATION FOR MEMBERSHIP OF
THE AUSTRALIAN CHINESE ENGINEERS ASSOCIATION
Mail Address: PO Box 1123, Chatswood, NSW 2067
Web Address: http://www-personal.usyd.edu.au/~victor/ACEA.html
NAME:
ENGLISH SURNAME _______________ GIVEN NAME ____________________
CHINESE NAME (
full name including the surname) ____________________PREFERRED TITLE Prof. Dr. Mr. Mrs. Ms. Miss
ADDRESS:
No./STREET ________________________________________________________
SUBURB _________________________ STATE _________ POSTCODE _______
CONTACT NUMBERS:
TELEPHONE _________ _________ MOBILE ____________ FAX __________
ELECTRONIC ADDRESS ______________________________________________
EMPLOYMENT:
CURRENT POSITION ______________________________________________
ORGANISATION ________________________________________
PAST (RELEVANT TO ENGINEERING)
POSITION ______________________________________________
ORGANISATION ________________________________________
PROFESSIONAL MEMBERSHIP (RELEVANT TO ENGINEERING):
1. TITLE ________________________________________________________
ORGANISATION ______________________________________________
2. TITLE ________________________________________________________
ORGANISATION ______________________________________________
EDUCATION:
1. _____________________________________________________________
2. _____________________________________________________________
3. _____________________________________________________________
AREAS OF SPECIALISATION:
1. _____________________________________________________________
2. _____________________________________________________________
LANGUAGE SKILLS:
1. _____________________________________________________________
2. _____________________________________________________________
3. _____________________________________________________________
NOMINATED BY (members of ACEA)*:
1. _____________________________________________________________
2. _____________________________________________________________
APPLICANT’S SIGNETURE:
_________________________ DATE: ______________
OFFICIAL USE ONLY:
EXAMINER'S OPINIONS:
QUALIFICATION COMMITTEE'S DECISION:
Please note, if you do not know any member from ACEA, please contact the following persons to make an appointment for interview: