NSBE Membership Form Question Title * 1. Title Mr Ms Mrs Dr Prof Question Title * 2. What is your name? Question Title * 3. What is your surname? Question Title * 4. What is your email address? Question Title * 5. What is your cellphone number? Question Title * 6. What date were you born ? Date Date Question Title * 7. What is your gender? Female Male Question Title * 8. What is your current residential province? Gauteng Western Cape KwaZulu-Natal Eastern Cape North West Limpopo Free State Mpumalanga Northern Cape Question Title * 9. What is your original birth province? Gauteng Western Cape KwaZulu-Natal Eastern Cape Limpopo Mpumalanga Northern Cape Free State North West Question Title * 10. Institution of your engineering degree/diploma University of Cape Town University of the Witwatersrand University of Stellenbosch University of Pretoria University of KwaZulu-Natal University of Johannesburg Walter Sisulu University Vaal University of Technology UNISA(former TechnikonSA) Tshwane University of Technology North-West Universty Nelson Mandela Metropolitan University Mangosuthu University of Technology Durban Institute of Technology Central University of Technology(Free State) Cape Peninsula University of Technology Question Title * 11. Your highest Engineering qualification BSc Aeronotical Engineering BSc Civil Engineering BSc Chemical Engineering BSc Electrical Engineering BSc Electro-Mechanical Engineering BSc Industrial Engineering BSc Information Engineering BSc Mechanical Engineering BSc Metallurgical Engineering BSc Mining Engineering Dipl Chemical Engineering Dipl Civil Engineering Dipl Construction Management Dipl Industrial Engineering Dipl Mechanical Engineering Dipl Metallurgy Dipl Mine Surveying Dipl Mining Engineering Dipl Quantity & Operations Management Dipl Town & Regional Planning Dipl. Electrical Engineering Question Title * 12. Other qualification Question Title * 13. Registration with ECSA None (not applied) None (applied waiting for outcome) Pr.Eng Pr.Tech Candidate Engineer Candidate Technologist Question Title * 14. Are you still doing your junior degree/diploma ? No - completed it Yes - doing year 1 Yes - doing year 2 Yes - doing year 3 Yes doing year 4 Question Title * 15. Which year did you finish (or planning to finish) your Engineering degree/diploma Question Title * 16. What are you specialties/key competencies (select max TOP 3) Aerospace Agriculture Mining Non-profits Automotive Banking & Finance Business Services Construction Education Energy & Utilities Engineering Design and/or Consulting Management Consulting FMCG Manufacturing & Distribution Marketing and Sales Operations Management General Management Oil & Gas Government Services Project Management Computer Hardware Healthcare & Medical Sports Insurance Investment Services General Manufacturing Maintenance Management Media Entertainment & Publishing Pharmaceuticals & Biotech Petrochemical Rail & Port Retail Distribution Software & Technology Telecomunications Transport & Logistics Travel & Hospitality Question Title * 17. Are you currently working ? Yes No Next