From c584540@showme.missouri.edu Mon May 6 11:24:54 1996 Date: Tue, 2 Apr 1996 19:16:15 -0600 (CST) From: "A. Koksal Hocaoglu" Reply-To: Kaya Buyukataman To: ** ITUMD ** ISTANBUL TEKNIK UNIVERSITESI MEZUNLARI DERNEGI ULUSLARARASI KURULUSU Subject: UYE KAYIT FORMU - MEMBERSHIP FORMU (fwd) Resent-Date: Thu, 4 Apr 1996 03:00:31 -0800 (PST) Resent-From: "Can K. SandalcI" Resent-To: Istanbul Technical University WWW Resent-Subject: _/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/ _/ To: ITU Alumni Scattered All Around The World _/ _/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/ UYE OLMAK VE DERNEGIN FALIYETLERINDE YER ALMAK ISTEYEN ARKADASLARIMIZ ISTEYEN ARKASALARIMIZ ICIN MURACCAT FORMU ASAGIDA VERILMISDIR. DERNEGIMIZIN HER BIR KOLUNDA, LOCAL VE MERKEZI IDARE HEYETLERINDE YARDIMA IHTIYACIMIZ VAR, KAYIT OLMAK, VE ELELE CALISMAK ICIN GOREV ISTEMEYI YARINA BIRAKMAYIN. MEZUN OLDUGUMUZ OKULUN BIZLERE IHTIYACI VAR. BASARILI BIR YARINLAR DILEKLERIMIZLE...ICRA KURULU _/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/ _/......................... ISTANBUL TEKNIK UNIVERSITESI _/ _/....... /\ /\ ....... <<>> _/ _/..... / | / | ..... <<>>_/ _/.. / // | ...<>_/ _/.. / // | .... Adr: 235 E River Dr. Suite 1502 _/ _/. /^/^ / / / ... E Hartford, CT, 06108, USA _/ _/.. /()|'`--/ _ / .. Phone-Fax : (203) 282-0251 _/ _/.. \_'/' '` \_' .. E-mail Int: _/ _/.. '//`--' '\ .. E-mail TR: _/ _/... || //--/ ' \ .. _/ _/..... \\ ||\_/\\ .. COMPONENT ALUMNI ASSOCIATION LOCATIONS _/ _/....... || \_/ ..Almanya-Ingiltere-Turkiye(2)-Japonya-Kanada(3) _/ _/.......1989 \\ \ .Fransa-Hongkong-Avusturya-Kibris-Belcika/Hollanda_/ _/........................Avustralya-Suudi Arabistan-Amerika(16)-Norvec _/ _/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/ _/ [ITU-MD (HomePage, Member List, and E-dergi "PETEK") ADDRESSES] _/ _/http://www.ece.orst.edu/~ituweb (Homepage) ftp.itu.edu.tr/pub/petek_/ _/http://geoweb.tamu.edu/~e0c1768 (GencITU) / _/http://www.ece.orst.edu/~ituweb/petek/ http://www.itu.edu.tr/petek.html/ _/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/ _/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/ _/ ITU-MD U Y E MURACAAT F O R M U _/ _/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/ Is this a new application or a renewal? Please check. "E-mail"le olan mUracaatlarda, Uyelik FormlarIndaki TUrkCe yazIlarda kargaSaya yol aCmamak iCin lUtfen aSaGIdaki alfabeyi kullanInIz: abcCdefgGhIijklmnoOprsStuUvyz ========================================================================= 1. INITIAL INFORMATION: ========================================================================= ------------------------------------------------------------------------- Name (first, middle, last) ------------------------------------------------------------------------- Father's Name ------------------------------------------------------------------------- Birth Place and Date ------------------------------------------------------------------------- If Married (Husband's/wife's) Name ------------------------------------------------------------------------- If Any Children Names and Birth Dates ------------------------------------------------------------------------- ========================================================================= 2. EDUCATIONAL RECORD: ========================================================================= ------------------------------------------------------------------------- Highest Degree: ------------------------------------------------------------------------- Major: ------------------------------------------------------------------------- ITU Graduation Year: ITU Freshman Year: ------------------------------------------------------------------------- Other Higher Education Institutions and Degrees: ------------------------------------------------------------------------- If not an ITU graduate reason for membership: ------------------------------------------------------------------------- Please write your title for ITU-MD membership card: (And also specify its abbrivation in brackets.) ------------------------------------------------------------------------- ========================================================================= 3. WORK (OR STUDY) PLACE INFORMATION: ========================================================================= ------------------------------------------------------------------------- Title: ------------------------------------------------------------------------- Affiliation: ------------------------------------------------------------------------- Division/Department: ------------------------------------------------------------------------- Street address: ------------------------------------------------------------------------- City, State, Zip: ------------------------------------------------------------------------- Telephone: ------------------------------------------------------------------------- Fax: ------------------------------------------------------------------------- E-mail: ------------------------------------------------------------------------- ========================================================================= 4. HOME ADDRESS ETC.: ========================================================================= ------------------------------------------------------------------------- Street address: ------------------------------------------------------------------------- City, State, Zip: ------------------------------------------------------------------------- Telephone: ------------------------------------------------------------------------- Fax: ------------------------------------------------------------------------- E-mail: ------------------------------------------------------------------------- ** Please my mail to HOME: WORK: ADDRESS ------------------------------------------------------------------------- ========================================================================= 5. MEMBERSHIP INFORMATION AND ASSOCIATION RECORDS: ========================================================================= ------------------------------------------------------------------------- I would like to join ITU-MD as ------------------------------------------------------------------------- a Regular Member Yearly dues $25.US (senelik aidat) | $ ------------------------------------------------------------------------- a Student Member Yearly dues $10.US (senelik aidat) | $ ------------------------------------------------------------------------- initiation and ITUMD ID (ilk gIrIS ve kimlik Ucreti) | $10. US ------------------------------------------------------------------------- My check payable to ITU-MD is mailed. Total: | $.. ------------------------------------------------------------------------- My picture for ITU-MD ID cart is mailed (check) | ------------------------------------------------------------------------- ------------------------------------------------------------------------- Membership: ------------------------------------------------------------------------- Membership type: ------------------------------------------------------------------------- Membership date approval: ------------------------------------------------------------------------- Establish Contact with E-Mail: Fax: Mail: Phone: ------------------------------------------------------------------------- Recommended by: 1. 2. ------------------------------------------------------------------------- * Aproved for membership : ------------------------------------------------------------------------- ========================================================================= 6. ITU-MD ACTIVITIES INFORMATION: ========================================================================= ------------------------------------------------------------------------- ** If you would like to participate committee activities and associations administration, please check the followings: ------------------------------------------------------------------------- KOMITELER VE GOREVLER: (Preferred Assignments): ============================================== 1. Bylaws (Tuzuk) .., By General Assembly, (Genel Secimle) __________ 2. Ethics (Disiplin).., By General Assembly, (Genel Secimle) __________ 3. ITU Book (ITU Kitap Yardimi) __________ 4. Employment (Is ve Staj Yeri Bulma) _________ 5. Membership (Uye Kayit ve Data Base), By General Assembly _________ 6. Membership Drive (Mezunlara Tanitim) _________ 7. Board of Trustees (See Bylaws for Req.) (Lutfen tuzugu inceleyin) __ 8. Young ITU (ITU-MD Genclik Kolu) _________ 9. May Turkish Week Activities Newyork (19 Mayis Turk Haftasi) _______ 10. Federasyon (FTAA) or Asembly (ATAA) Rep. (ITU-MD Temsilciligi) _____ 11. Technical Conference Organization (Konferans Duzenleme) __________ 12. Regional Meetings Organization (Bolgesel Toplantilar) ________ 13. Regional Board of Directors (Bolgesel Idare heyeti) (Secimle) _____ 14. ITU Scientific Aid (ITU Lab. Malzemesi Ozel Yardim) _________ 15. ITU-MD TUrkiye Newsletter (Mezunlar Dernegi Dergisi) __________ 16. Central Focal (Kilit Noktasi, E-mail olmayanlara haber iletimi) ___ 17. Voice Mail (Telefon Haberlesme Sistemi Idaresi) _________ 18. Central Fund raising (Klup Binasi ve Ileri Projeler Yardim) ______ 19. ITU Special fund Raising (ITU Ozel Proje Yardim) _________ 20. ITU-MD WWW Homepage ________ 21. ITU-MD E-Dergi PETEK ___________ 22. Other (Onerdiginiz diger bir saha var mi?) __________