IEEE
 

IEEE Affiliate to Member Conversion Application

As an IEEE Society Affiliate, you are already a vital member of the IEEE community.  We are very pleased that you have decided to become a member of the IEEE as well. By joining IEEE, you will expand the benefits and services available to you!

If you have not yet renewed for 2016, please use the IEEE Renewal Website to complete your conversion request. 

If you have already renewed for 2016, please complete this form and fax, mail or call the IEEE Contact Center along with your credit card information.  Enjoy your paid membership through 31 December 2016.  New IEEE members pay half price from 1 March to 15 August!

Please direct your inquiries to the IEEE Support Center.

Welcome to IEEE membership!

These options are available to you. Please choose one.
1) Complete all information, print and fax this form with credit card to +1 732-562-6380, attention "Admission & Advancement Department" or
2)
Mail the form with payment to: IEEE 445 Hoes Lane, Piscataway, NJ 08854 Attention: Admission & Advancement Department or
3) Call the IEEE Contact Center at  +
1.732.981.0060 Worldwide, +1.800.678.4333 US & Canada (fastest method) or
4) Online Chat is available 24/5. Sunday 4:30pm - Friday 4:30pm ET at at: https://supportcenter.ieee.org

A. Name:

*Last/Family/Surname
*First/Given name:
*Affiliate Number:

B. Mailing Address: 

*Street:
 
*City:
*State/Province:
Postal Code:
*Country:
*Email Address:
Home Phone Number:
C. Educational and Professional Information: *For IEEE grade determination,  please complete the
 educational and employment histories below.

Professional Information

Total Years in Profession:
Current technology focus:
If your technology focus is not found in the list,
please provide:
Employer:
Education Information
Did you graduate from a three to
five year program at a university level?:
Yes       No
Undergraduate field of study?:
Undergraduate program accredited?
Yes      No      Do not know

An undergraduate or first university degree is a minimum requirement for some grades of membership. You can add certifications or advanced degrees to "My Profile" at any time.

  
D. Payment Due (Dependent on your geographical location)  
Dues
All Dues in US$
US Canada
GST
Canada
GST & QST
Quebec
Canada HST
Prince Edward Island
Canada HST
- New Brunswick
- New Foundland
- Ontario
Canada HST
Nova Scotia

Africa,
Europe,
Middle East

Latin
America
Asia
Pacific
2016 IEEE Dues  US$99.501 US$86.67 US$94.00
US$93.29 US$92.55 US$94.02 US$80.00  US$75.50 US$76.00
Affiliate Fee Credit* -US$36.75  -US$38.59 -US$42.25
-US$41.89 -US$41.53 -US$42.41 -US$36.75 -US$36.75 -US$36.75
Net Total Due  US$62.75  US$48.08 US$51.55
US$51.40 US$51.02  US$51.61  US$43.25 US$38.75  US$39.25
1This amount represents base dues plus IEEE-USA assessment.

*You have already paid this amount

IEEE Canadian Business No. 125634188

E. Payment Options:

* Credit Card Type
 American Express       Visa       MasterCard  
     Diners Club       Discover
*Card Holder Name
*Credit Card Number:     

*Amount:

See "Net Total Due" above for amount.

*Expiration Date:

*Year:

By checking this box and submitting this application through fax or postal mail, I hereby make application for IEEE membership and acknowledge that I have read and agree to the IEEE Terms of Membership which states "By becoming an IEEE Member, you agree to: Abide by the IEEE Constitution, Code of Ethics, Bylaws and Policies (the "Governing Documents") and any updates or amendments to the Governing Documents posted by IEEE; Support the enhancement of IEEE principles, objectives and activities; and Meet the monetary obligations required for membership such as the payment of dues and applicable assessments. In addition, Life Members shall be obligated to confirm annually the desire to continue to receive services and publication(s) to which they are entitled. You may access the most up-to-date versions of the Governing Documents at: http://www.ieee.org/about/corporate/governance. Updated versions of the Governing Documents shall be effective upon posting."


1) Complete all information, print and fax this form with credit card to +1 732-562-6380, attention "Admission & Advancement Department" or
2)
Mail the form with payment to: IEEE 445 Hoes Lane, Piscataway, NJ 08854 Attention: Admission & Advancement Department or
3) Call the IEEE Contact Center at  +
1.732.981.0060 Worldwide, +1.800.678.4333 US & Canada (fastest method) or
4) Online Chat is available 24/5. Sunday 4:30pm - Friday 4:30pm ET at at: https://supportcenter.ieee.org

Please visit our IEEE Support Center website where you may find the answers to your question at: https://supportcenter.ieee.org.

The IEEE Contact Center is available to assist  you 24/5, Sunday 4:30pm - Friday 4:30pm ET Reach the IEEE Contact Center on-line at: www.ieee.org/contactcenter
- or - by telephone at: 1.732.981.0060 Worldwide, 1.800.678.4333 US & Canada


* Required Information

IEEE