INDIAN INSTITUTE OF CHEMICAL ENGINEERS rH. Rey Building, Raja Subodh Mulick Road, Kolkata - 700 092 Phone (093) 2414-6670 & 2412-0814, Fax (089) 2414 6670, E-malichehg@ vsnl.com; iche @ glasciO1.vsn.netin ASSOCIATE MEMBERSHIP EXAMINATION FORM (MARCH/SEPTEMBER 20. Last Date of receipt of application; [MARCH Exam. _|tst December of the preceding veer. | [SEPTEMBER Exam|s0m dune of he same year] 1-RollNo, 2. Last Registration No: Ph, No, mat; 3. Name in ful (in BLOCK LETTERS) as in Registration Form, Leave a box blank in between words. FIST NAME: MOOLE NAME SURNAME CTT TTT TT I I [TT 4. Father's Name (in BLOCK LETTERS) 5. Present Address (in BLOCK LETTERS) PIN CODE 6. Permanent Address (in BLOCK LETTERS) = = PIN CODE N.B.: Tho photograph is to be attested by Medical Officer / Bank Manager / Principal of any Collaga / Headmaster of any School (Without Attestation, Form will be rejected.) INDIAN INSTITUTE OF CHEMICAL ENGINEERS Dr. H.L. Roy Building, Raja Subodh Mullick Fload, Kolkata - 700 032 ASSOCIATE MEMBERSHIP EXAMINATION FORM (MARCH/SEPTEMBER 20. ....) celal Paste a recon hatte Signature o' Applicant; ate Name infu; Address :— incon» FOR OFFICE USE ONLY [Examination Centre Pll No, Fogistration No. |checkes by Date Honorary Secretary Controller ot Examination N.B. : The photograph is tobe attested by Medical Officer / Bank Manager / Principal of any College / Headmaster of any School (Without Attestation, Form will be rejected.) INDIAN INSTITUTE OF CHEMICAL ENGINEERS Dr. H.L. Roy Building, Raja Subodh Mullick Road, Kolkata - 700 032 ASSOCIATE MEMBERSHIP EXAMINATION FORM (MARCH/SEPTEMBER 20. ‘ADMIT CARD ey || egret, | Styne ct Apeants ate; | Moment; a cress: Pin Code FOR OFFICE USE ONLY lExamination Centre Fall No. Registration No. ‘ | oat = reeearéecem —__trctraonatn |7. Choice of Examination Centres, any three amongst the following : [Please write in order of preference in the box provided) Ahmedabad, Baroda, Chandigarh, Chennai, Coimbatore, Delhi, Hyderabad, Kanpur, Kolkata, Mumbai, Surat Visakhapatnam, Thrissur iT 2 a 8. Amount of examination fees remitted Rs. D/DINo. Bank Date. | declare that all the particulars stated are true to the best of my knowledge and belief, | shall abide by the decision of the Couneilin all matters regarding Associate Membership Examination Points to Note |) Examination fees as mentioned below must accompany the application form. Fees are to be paid by Bank Oratt ‘rau in favour of “Indian Institute of Chemical Engineers’ payable at Kolkata. Payment by Money Order, Cheque or Postal Order are not acceptable. Examination fees once pald can neither be returned nor adjusted for subsequent examinations, Feos ‘or Parts | IA & IIB : Minimum fee payable is Rs. 500/-(enttes the candidate to appear in maximum two subjects) Adational fee per subject is Rs. 200/-: Fees for Part Il (Home Paper): Rs. 900/- |i) A selt-addressed envelope. For postage of admit card & Markshect, add Rs. 100/- (extra) with the examination fees i) Admit card willbe sént a fortnight before thé commencement of the Examination Ploase tick ( ¥ ) in the appropriate box against the subjects you wish to appear. Option exercised at the time of ‘submission of application cannot be changed lator. “Part-I Part =A Part-1IB (Select any one) | 1. Mathematics 1. C1 Chemical Process, Principles 1. 1 Production Management and 2 11 Physics 2 C1] Fluid and Partcle'Mechanics Industrial Relations 3. C1 Chemistry 3. C1 Heat Transfer C7 Industria! Pottution Contrat 4. Mechsnical Engineering 4.) Mass Transfer 3. 1] Petroleum Refinery Engineering 5. C1 Electrical Engg, and Electronics 5, C] Chemical Engg. Thermodynamics ‘and Petrochemicals 6 C1 Engineering Drawing 6 (1 Chemical Reaction Engineering 4] Fertitzer Technology 7. © General Chemical Technology 7. [] Instrumentation and Process Control §. (] Polymer Technology 8. C1 Elements of Computer 8, C1 Chemical Plant and Equipment 6. C1 Industrial Safety and Hazard Programming Design Analysis NB. “indian institute of Chemical Engineers reserves the right to inform Part i the candidate's employer or other appropriate authority in case of | ———————-—~ adopiion of malpractice by a candidate in the examination.” 1. C1 Home Paper Pease tick ( ¥_) in the appropriate box against the subjects you wish to appear. Option exercised at the time of ‘submission of application cannot be chenged later, _ Part=1 Part = 1A Part-1IB (Select any one) | 1. 10 Mathematics 1, C1 Chemical Process Principles 1. 0 Production Management and 2. OO Physics 2. C1 Fhid and Particle Mechanics Industrial Relations 3. Chemistry 3. C0 Heat Transfer 2. 1 Industrial Potion Control 4. Mechenical Engineering 4.) Mass Transfer 3. C1 Petroleum Refinery Engines 5. C1 Electrical Engg. and Electronics 5. C] Chemical Engg. Thermodynamics and Petrochemicals 6. C1 Engineering Drawing 6 C1 Chemical Reaction Engineering 4-1 Fertiizer Technology 7. C1] Generel Chemical Technology 7. C] Instrumentation and Process Control 5. [] Polymer Technology 8. [1] Elements of Computer 8. [1 Chemical Piant and Equipment 6 C1 Industrial Safety and Hazard Programming Design ‘Analysis NB. “Indien Insitute of Chemical Engineers reserves the ight to inform Parti _| the cancidate's employer or other appropriate authority in case of Aacopiion of malpractice by a candidate in the examination” 1. Ol Home Paper