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2016 Student Membership Form

This document provides information about student membership in the IEEE Computer Society, including eligibility, dues, and membership options. To be eligible, students must be enrolled at least half-time in an eligible graduate or undergraduate program and apply before graduating in 2016. Membership provides access to the Computer Society Digital Library and is valid through December 31, 2016. Students can choose between full-year or half-year rates depending on when their application is received.

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Sayed Mohsin Raza Naqvi
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© © All Rights Reserved
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95 views

2016 Student Membership Form

This document provides information about student membership in the IEEE Computer Society, including eligibility, dues, and membership options. To be eligible, students must be enrolled at least half-time in an eligible graduate or undergraduate program and apply before graduating in 2016. Membership provides access to the Computer Society Digital Library and is valid through December 31, 2016. Students can choose between full-year or half-year rates depending on when their application is received.

Uploaded by

Sayed Mohsin Raza Naqvi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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STUDENT MEMBERSHIP PACKAGE

Computer Society Digital Library (CSDL) included


with your IEEE Computer Society membership.

ELIGIBILITY
Student members must carry at least 50% of a full-time graduate or undergraduate academic
program. Current IEEE student members can join Computer Society for US $8.00 and receive access
to the Computer Society Digital Library.
Students must apply for membership prior to graduation in 2016.

SCHEDULE OF DUES
Membership is annualized to and expires on 31 December 2016. Pay full or half-year rate depending
on the date of receipt by IEEE Computer Society as illustrated below.
Prices expire on 15 August 2016.

MEMBERSHIP OPTIONS

All prices are in U.S. dollars

FULL YEAR

HALF YEAR

Applications received
16 Aug 2015 29 Feb 2016

Applications received
1 Mar 2016 15 Aug 2016

Join both IEEE and IEEE Computer


Society, plus get access to the CSDL
U.S. AND CANADA

$40.00

$20.00

REST OF THE WORLD

$35.00

$17.50

I already belong to IEEE and want to


join Computer Society, plus get access
to the CSDL

$8.00

$4.00

Student members also receive Computer magazine as a Digital Edition (print version is an additional fee).

JOIN IEEE COMPUTER SOCIETY TODAY!


Complete the back of this form, or apply for membership online at www.computer.org/join
When applying online, please be sure to have your educational information and credit card
readily available.
Mail or fax your completed form to:
IEEE Computer Society
445 Hoes Lane
Piscataway, NJ 08854-4141 USA
Phone: +1 732-981-0060
Fax: +1-732-562-6380

Join online at www.computer.org/join

IEEE Computer Society: Student Membership Application


Start your membership immediately: Join online www.computer.org/join
Complete this form, by typing or printing in capital letters. Use only English characters
and abbreviate only if using more than 40 character and spaces per line. Incomplete applications cannot be processed.

PERSONAL INFORMATION

EDUCATION INFORMATION

Please PRINT your name, as you want it to appear on your membership card and
correspondence. As a key identifier, circle your last/surname.

Please complete school/name information. No abbreviations please. This


information is required to qualify for student membership.

Male

Female

Date of Birth (Day/Month/Year)_________________


UNIVERSITY

TITLE

FIRST/GIVEN NAME

MIDDLE

LAST/SURNAME

ADDRESS DURING ACADEMIC YEAR

SCHOOL OR COLLEGE (if applicable) CAMPUS


STREET ADDRESS

STREET ADDRESS
CITY

STATE/PROVINCE

POSTAL CODE

COUNTRY

PHONE FAX

EMAIL

CITY

STATE/PROVINCE

POSTAL CODE

COUNTRY

DEGREE TITLE EXPECTED

EXPECTED GRADUATION DATE MO/YR

CURRENT DEGREE PROGRAM (Check one)

FAMILY/HOME ADDRESS

UNDERGRADUATE:
GRADUATE:

STREET ADDRESS

2 or 3 year
Masters

4 or 5 year
Ph.D.

DO YOU HOLD OTHER DEGREES?


Yes (Complete Below)

No

CITY

STATE/PROVINCE

POSTAL CODE

COUNTRY

HIGHEST TECHNICAL DEGREE RECEIVED

EMAIL

PROGRAM MAJOR/COURSE STUDY

PHONE FAX

MO/YR RECEIVED

AREA OF CONCENTRATION

SEND ALL IEEE MAIL TO:

Address During Academic Year

Which of the following best describes the area of your degree? Please check one:

Family/Home Address

Engineering
Computer Sciences and Information
Technologies
Physical Sciences
Biological and Medical Sciences

To better serve our members and supplement member dues, your postal mailing
address is made available to carefully selected organizations to provide you with
information on technical services, continuing education and conferences. IEEE
does NOT rent out your e-mail address.
Please check this box if you do NOT want to receive these postal mailings.
Are you now or were you ever a member of IEEE?
If yes, provide, if known:

Yes

No

Mathematics
Technical Communications,
Education, Management, Law and Policy
Other (please specify):


FULL UNIVERSITY NAME, CAMPUS AND PREVIOUS NAME IF APPLICABLE


CITY

STATE/PROVINCE

POSTAL CODE

COUNTRY

ADDITIONAL DEGREES HELD

MO/YR RECEIVED

PROGRAM MAJOR/COURSE STUDY

AREA OF CONCENTRATION

MEMBERSHIP NUMBER

WERE YOU REFERRED TO IEEE?


Yes

No

If yes, provide the following:


FULL UNIVERSITY NAME, CAMPUS AND PREVIOUS NAME IF APPLICABLE

MEMBER RECRUITER NAME

IEEE RECRUITERS MEMBER NUMBER (required)

ATTESTATION
I attest that:
I am currently a registered undergraduate student at the university level
I am currently a registered graduate student and have graduated from a three to
five year academic program at the university level
My undergraduate program falls within:
Engineering
Computer Sciences and Information
Technologies
Physical Sciences
Biological and Medical Sciences

Mathematics
Technical Communications,
Education, Management, Law and Policy
Other (please specify):


My undergraduate program is accredited in the country where


Yes
No
Do Not know
the institution is located.
I am taking at least 50% of a full-time academic program or course
Yes
No
of study in an IEEE designated field of interest.

CITY

STATE/PROVINCE

POSTAL CODE

COUNTRY

PAYMENT AMOUNT (See other side for dues)


PAYMENT METHOD
All prices are quoted in US dollars. You may pay for IEEE membership by credit
card (see below), check or money order payable to IEEE, drawn on a U.S. bank.
Canadian residents pay 5% GST or 13% HST..................................TAX $
AMOUNT PAID.............................................................................. TOTAL $
Check

Visa

MasterCard

Discover

American Express

Diners Club

Credit Card Number


Expiration Date (Month/Year)____________ Cardholders 5-Digit Zipcode
(Billing Statement Address USA Only)

NAME AS IT APPEARS ON CARD

SIGNATURE

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