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Membership Application Form
Please note that this form can also be downloaded and filled manually offline by locating the link on the membership information page. All claims by applicants shall be investigated All information would be treated with confidentiality Submission checklist Application form should be returned with the following a. two recent passport photographs b. copies of academic and professional certificates c. NYSC discharge Certificate. d. referees reports in confidential cover. e. detailed curriculum vitae to include the following information (1) institution attended and qualification obtained with dates (2) professional courses attended in the last five (5) years with dates (3) previous organisation(s)/appointment(s) with date (4) area(s) of specialization Application Fee Membership application/processing fee of =N=1,000 (non-refundable), payable to the Institute of Piping Engineers in Nigeria(IPEN).Your payment details must be completed in the application form. United Bank for Africa (UBA) Account N0 0310000023 Account Name: Institute of Piping Engineers in Nigeria (IPEN)
Grade (*)
Fellow
Corporate
Associate
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Student
Member
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Full Name (*)
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Email Address (*)
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Home Address (*)
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Home Phone
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Office Address
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Office Phone
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Date of Birth {dd/mm/yyyy} (*)
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Place of Birth
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Gender (*)
Male
Female
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Marital Status (*)
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Cell Phone Number (*)
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Nationality (*)
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Academic Institutions attended with qualifications obtained (*)
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Please upload copies of relevant certifications
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Piping Specialty with years of experience stated (*)
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Job History in chronological order (*)
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Areas of Interest for Piping Development
Design & Layout
Stress Analysis
Piping Materials
Piping Support
Others
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Please fill in the details of your referee in the segment below. One of the Referees must be an up to date financial member of IPEN
Title of Referee
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Name of Referee (*)
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Relationship with Referee
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Address of Referee
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Email Address (*)
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Name of Referee (*)
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Date (*)
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Address of Referee
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Email Address (*)
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