Fillable M EMBERSHIP APPLICATION FORM (Insitute of Marine Engineering, Science and Technology)

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M EMBERSHIP APPLICATION FORM (Insitute of Marine Engineering, Science and Technology)

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The M EMBERSHIP APPLICATION FORM (Insitute of Marine Engineering, Science and Technology) form is 7 pages long and contains:

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Country of origin: UK
File type: PDF

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PLEASE WRITE IN BLOCK CAPITALS OR CLICK TO ENTER TEXT
Ti
tle
First Name
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Middle Name
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Surname
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Date of Birth
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Gender
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Nationality
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OFFICE USE ONLY
Membership Number
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Date Received
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Membership Level Applied For
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Registration Applied For
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ICP Date / Course Ref
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Membership Committee Date
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PRI Date
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Membership A1 ☐ A3 ☐ B ☐ Registration A1 ☐ A3 ☐ B ☐
Application Processed ☐ Payment Processed ☐ Scanned to CRM ☐ Scan checked ☐
M
EMBERSHIP APPLICATION FORM
Please complete this form and return to IMarEST along with your up to date Professional
Development Report (Refer to the Guide on the website for further details) and
Photocopies of your Academic certificates, signed by your referee.
Please return by post to: Or electronically via:
IMarEST Membership Team
imarest.wetransfer.com
1 Birdcage Walk
London
SW1H 9JJ
UK
For more information contact the Membership Team on: +44 (0)20 7382 2694 or visit our
website: www.imarest.org
1. CONTACT DETAILS: Please indicate preferred e-mail address for correspondence Home
☐ OR Business ☐
HOME
Address
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Postcode
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Country
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Email
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Telephone
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BUSINESS
Address
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Postcode
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Country
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Email
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Telephone
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2. MEMBERSHIP AND REGISTRATION (IF APPLICABLE)
MEMBERSHIP LEVEL
Please complete ALL sections of the form if applying for Fellow, Member, Associate Member
If applying for Affiliate please fill out the following sections: 1, 2, 3, 5, 8, 9, 10, 13
(Please note: you will not need to send in copies of your Academic Certificates for Affiliate applications, however,
we will require an up to date CV from you)
F
ellow
Member
Associate
Affiliate
REGISTRATION: I apply to register as…
EN
GINEERING
CEng (Chartered Engineer)
CMarEng (Chartered Marine Engineer)
IEng (Incorporated Engineer)
IMarEng (Incorporated Marine Engineer)
EngTech (Engineering Technician)
MarEngTech (Marine Engineering Technician)
S
CIENCE
CSci (Chartered Scientist)
CMarSci (Chartered Marine Scientist)
CMarSci (Hydrography)
CMarSci (Oceanography)
RMarSci (Registered Marine Scientist)
T
ECHNOLOGY
CMarTech (Chartered Marine Technologist)
RMarTech (Registered Marine Technologist)
MarTech (Marine Technician)
INTERIM REGISTRATION
(for applicants who satisfy the academic requirements of
registration whilst they obtain the professional competencies)
3. MEMBERSHIP OF OTHER PROFESSIONAL OR TECHNICAL SOCIETIES
(Please include name of organisation/ grade of membership / Engineering Council and/or Science Council
registration level & number)
N
ame of Organisation
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Grade of Membership
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Engineering Council and/or Science Council
registration level
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Engineering Council and/or Science Council
registration number
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4. REFERENCES
Please identify an appropriate referee, a responsible person of standing in the marine community, who knows you and
your work well (for example, your course tutor, a senior manager or officer at work, a corporate member of the
IMarEST). Once you have completed the rest of this application form, please ask your referee to fill in the section below
and to sign and date photocopies of your certificates as true copies of the originals.
I
, the undersigned, recommend the above applicant, from personal knowledge, for membership of the IMarEST. I
append my initials against all statements by the candidate, which I can verify.
N
ame
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Position
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Company
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Telephone
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Email
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IMarEST - Membership Category &
Number (if applicable)
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Engineering Council or Science
Council - Registration Category &
Number (If applicable)
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Capacity in which the applicant is
known to you
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Length of time you have known the
applicant
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I support his/her application for membership.
S
ignature
Date
5. If an IMarEST Member has referred you to the IMarEST please complete their name and membership number
in the below fields
N
ame
Membership Number
6. ACADEMIC QUALIFICATIONS (THIS SECTION MUST BE COMPLETED – ‘please see CV’ will NOT be accepted
Your qualifications can help you to demonstrate evidence of your knowledge. You must submit authenticated
copies (i.e. initialled by your referee as true copies of the originals) of your qualification certificates with your
application form.
S
tart and Finish
Dates
Establishment (e.g
University of Newcastle)
Degree/Diploma/Certificate
(e.g. MEng(Hons) Marine Engineering)
Initials
of
Referee
7. SUMMARY OF CAREER PROGRESSION (THIS SECTION MUST BE COMPLETED – ‘please see CV’ will NOT be
accepted)
Please include details of your current or most recent job role and attach your Professional Development Report and
a plan of CPD activities identifying the key responsibilities and accountabilities you have had during your career to
date.
D
ates Current/Most recent job role
Initials of
Referee
8. GENERAL AREAS OF PRACTICE (Please tick as appropriate)
☐ Ship design, construction, maintenance
& decommission
☐ Marine Engineering Systems and
Equipment
☐ Navigation & Communication
☐ Fishing, Aquaculture & Biotechnology
☐ Marine Renewables
☐ Natural Hazards
☐ Marine Leisure
☐ Recruitment & Manning
☐ Other, please state
☐ Ports and Harbours
☐ Power & Propulsion
☐ Marine Environment & Pollution
☐ Marine Finance, Insurance & Risk
☐ Marine Safety & Security
☐ Offshore Oil & Gas
☐ Education & Training
☐ Research & Consultancy
☐ Commercial Shipping
☐ Defence and Naval Engineering
☐ Coast & Ocean Mapping & Hydrography
☐ Coastal & Shelf Seas
☐ Marine Law, Governance & Regulation
☐ Oceanography Climatology & Marine
Meteorology
☐ Underwater Technology & Operations
☐ Publishing/Media
☐ Societies, Associations & NGO’s
9. DECLARATION
I hereby confirm that the statements made in this application are, to the best of my knowledge and belief, correct. I agree
to abide by the IMarEST’s Code of Professional Conduct (please see our website for details), to maintain my Continuing
Professional Development and to uphold the v
alues and principles of the IMarEST.
Signa
ture: _____________________________________________________ Date: ____________________________________
The IMarE
ST is committed to protecting and respecting your privacy. In accordance with the EU General
Data Protection Regulation, the personal data collected in this form will be processed securely in order to
provide you with the service(s) requested. To learn more about how the IMarEST collects, processes and
protects personal information, or to contact us about data protection, please see our Privacy Notice
(www.imarest.org/privacy
).
10. MEMBERSHIP AND PAYMENT DETAILS (01/10/2020 – 30/09/202
1)
The IMarEST Membership year runs 1st October to 30th September.
• Candidates applying between 1st October and 30th April, will pay the full annual fee for the current membership year
• Candidates applying between 1st May and 31st July will pay the annual fee pro-rata till the end of the membership year
• Candidates applying between 1st August and 30th September will pay the full annual fee for the following membership year
Your payment will be composed of an assessment fee (if applicable), your annual subscription fee, and your registration entrance fee (if applicable).
GROUP A MEMBERSHIP FEES - ALL COUNTRIES NOT LISTED IN GROUP B
Assessment Fee GBP AUS$ Euro SG$ US$ You Pay
Member & Fellow £65 $131 €78 $119 $88
Enter
Annual Subscription
Fellow £287 $580 €344 $525 $389
Enter
Member £248 $501 €298 $454 $336
Enter
Associate Member £158 $319 €190 $289 $214
Enter
Affiliate £158 $319 €190 $289 $214
Enter
GROUP B MEMBERSHIP FEES -
,
Assessment Fee GBP AUD$ Euro SG$ US$ You Pay
Member & Fellow £45 $91 €54 $82 $61
Enter
Annual Subscription
Fellow £126 $255 €151 $231 $171
Enter
- AFGHANISTAN, ANGOLA, BANGLADESH, BENIN, BHUTAN, BOLIVIA, BOTSWANA, BRAZIL, BURKINA FASO, BURUNDI, CABO VERDE, CAMEROON,CENTRAL
AFRICAN REPUBLIC, CHAD, COLOMBIA, COMOROS, CONGO, COOK ISLANDS, COTE D’IVORE, DJIBOUTI, ECUADOR, EGYPT, EL SALADOR, ERITREA, ESWATINI, ETHIOPIA, FEDERATED STATE OF MICRONESIA, FIJI, GABON, GAMBIA, GHANA,
GUINEA, GUINEA-BISSAU, GUYANA, HAITI, HONDURAS INDIA, INDONESIA, JORDAN,KAZAKHSTAN, KENYA, KIRBATI, KOREA, DEMOCRATIC REP, KYRGYZ REPUBLIC, LAO PDR, LESOTHO, LIBERIA, MALAWI, MALAYSIA, MALDIVES, MALI,
MAURITANIA, MEXICO, MIRCONESIA, MOLDOVA, MONGOLIA, MOZAM
BIQUE, MYANMAR, NAURU, NICARAGUA, NIGERIA, NIUE, PAKISTAN, PALAU, PAPUA NEW GUINEA, PHILIPPINES, REPUBLIC OF THE MARSHALL ISLANDS, ROMANIA, RWANDA,
SAMOA, SAO TOME AND PRINCIPE, SENEGAL, SIERRA LEONE, SOLOMON ISLANDS, SOMALIA, SOUTH SUDAN, SRI LANKA, SUDAN, SYRIA,TAJIKSTAN, TANZANIA, THAILAND, TIMOR-LESTE, TOGO, TONGA, TUNISIA, TURKEY, TUVALU,
VENEZUELA, , UKRAINE, UZBEKISTAN, VANUATU, VENEZUALA, WEST BANK AND GAZA, YEMEN REPUBLIC, ZAMBIA, ZIMBABWE
Member £108 $218 €130 $198 $146
Enter
Associate Member
£
96
$194 €115 $176 $130
Enter
Affiliate £96 $194 €115 $176 $130
Enter
REGISTRATION FEES
Assessment Fee – applicable for existing members who are applying for registration only. Fees only apply to registrations with a *
GBP
AUS$
Euro
SG$
US$
You Pay
Assessment Fee – Group A £65 $131 €78 $119 $88
Enter
Assessment Fee – Group B £45 $91 €54 $82 $61
Enter
REGISTRATION ENTRANCE FEES
Registration Category GBP AUS$ Euro SG$ US$ You Pay
CEng*/CSci*/CMarSci*/CMarTech*
£9
8
$198 €118 $180 $99
Enter
IEng*/IMarEng*/RMarSci*/RMarTech* £90 $182 €108 $165 $87
Enter
EngTech/MarEngTech/MarTech £63 $128 €76 $116 $48
Enter
Interim Registration £56 $113 €67 $102 $38
Enter
PUBLICATIONS
• All members will receive The Marine Professional in digital format as part of their membership fees
• Associate Members, Members and Fellows will receive The Marine Professional in paper format as part of their membership fee
Affiliate members must place an order below if they wish to receive The Marine Professional in Paper format
Subscription GBP You Pay
The Marine Professional
(Paper format – Affiliates only)
£49.99
Enter
Publications – Member Rates GBP AUD$ Euro SG$ US$ You Pay
Journal of Marine Engineering and
Technology (JMET)
£75 $152 €90 $137 $102
Enter
Journal of Operational Oceanography
(JOO)
£45 $91 €54 $82 $61
Enter
JMET and JOO – Both at Special Price
£105 $212 €126 $192 $142
Enter
Your payment
Total to Pay
Enter
Prices are correct at the time of printing. To check current prices please visit
our website.
Alternatively, please indicate that you are happy for any price change to be
applied to your application by ticking here ☐
11. DEADLINES FOR APPLICATION SUBMISSIONS
T11. DEADLINES FOR APPLICATION SUBMISSIONS
The IMarEST holds 6 Individual Case Panel Meetings and 6 Membership Committee Meetings annually. The final dates
for submission are listed below:
Individual Case Panel (ICP) – required prior to Membership Committee if your qualifications are unaccredited
4th January 2021, 1st March 2021, 3rd May 2021, 5th July 2021, 6th September 2021.
Membership Committee
19th January 2021, 23rd March 2021, 28th May 2021, 20th July 2021, 21st September 2021
12. APPLICANT’S CHECKLIST
APPLICANTS FOR PROFESSIONAL REGISTRATION MUST COMPLETE THE PROFESSIONAL REPORT AS PER THE EXEMPLAR,
LISTING THEIR EXPERIENCE AGAINST EACH INDIVIDUAL COMPETENCY
13. PAYMENT DETAILS
☐ Cheque (please make payable to “The IMarEST”)
☐VISA Credit ☐ VISA Debit ☐MasterCard ☐Amex (GBP payments only)
Card Number: XXXX / XXXX /
XXXX / XXXX
Expiry date MM/ YY
Security number: XXXX
Name on card: (please print) Click here to enter text.
Pay
ment Details
Ins
truction to your bank or building Society to pay by Direct Debit
Please fill in the form and send to:
Membership, The IMarEST, 1 Birdcage Walk,
To: The Manager
Bank/Building
Society
Address
Postcode
Name(s) of Account Holders
Bank/Building Society account number
Branch Sort Code
1.
☐
2. ☐
Personal details completed
Contact details completed
7.☐
7b.☐
Qualifications listed (if appropriate)
Authenticated copies of academic qualifications attached
(if appropriate)
3.☐
3b.☐
Category of membership completed
Registration requirements completed (if
appropriate)
8. ☐
Professional report or CV attached.
4. ☐
Membership of other societies completed.
9.☐
Membership and payment details completed
5. ☐
Applicant’s declaration signed.
10.
☐
General areas of practice completed
6. ☐
Referee details completed.
For UK bank holders wishing to pay by Direct Debit send no money now. Enter your Bank or Building Society details in the Direct Debit
mandate section below, and return the whole form with your application to the IMarEST. (Note - we cannot accept scanned mandates)
If you wish to pay your Direct Debit Annually please indicate so on the form below. The payment will be taken at the beginning of the following month. The
IMarEST will write to you prior to taking any further membership subscription payments, which fall due annually on or around 1st October.
Annual Payment
Service User Number
9
9
5
2
4
7
Reference
FOR IMarEST OFFICIAL USE ONLY
This is not part of the instruction to your bank
Instruction to your bank or building society
Please pay The IMarEST Direct Debits from the account detailed
in this instruction subject to the safeguards assured by the Direct
Debit Guarantee.
Signature(s)
Date
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M EMBERSHIP APPLICATION FORM (Insitute of Marine Engineering, Science and Technology)

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Completed 28 June 2021

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