Extension of IIM Core Awards 2020 deadlines till 15th September 2020
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Application Form for Student Membership

THE INDIAN INSTITUTE OF METALS

Student Membership Enrolment: AMIIM Category (ST02)

1. Name in Block Letters:

First Name* :
Middle Name :
Last Name* :

2. Sex* :

3. Date of Birth* :

4. Father's Name

5. Address for correspondence* :

Pincode* :
Phone No. :
Mobile No.* :
Fax :
Email Id* :

6. Highest Academic & Professional Qualification [Proposed][From Matriculation onwards]*

Examination Univ./Board Year/Month of Passing Marks obtained/Total marks Percentage/Div. Subjects

7. Professional experience [From the Current Experience]*

Organization/Institute Name Tenure [From/To] Designation Location

8. Primary Field of Interest:(Please mark 1,2,3 in the in order of preference)

Ferrous
Non Ferrous
Metal Science
Energy & Enviroment
Others
Production Ferrous
Sponge Iron
Production Non Ferrous
Copper
Aluminium
Lead/Zinc
Forging
Casting
Pipes
Mining & Beneficiation
Quality Control

Manufacturing
Equipment
Design & Engineeing
Infrastructure
Research & Development
Consultancy
Education


9. Name of the IIM Chapter you intend to be attached

10. Documents to be submitted :

Qualification type :

Declaration by the Applicant:


I hereby declare that the information given in this application is true and correct to the best of my knowledge and belief. In case any information given in this application proves to be false or incorrect, I shall be responsible for the consequences.