ITU ALUMNI Membership Form

Please try to fill in all the fields, this information is important for us and will be kept confidential.

To avoid Turkish character confusion please use the alphabet below.

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INITIAL INFORMATION

First Name :		Last Name:
Father's Name:
Birth place, Date :

If Married

Husband's / Wife's Name:

If Any Children

Names	Birth Dates

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 ITUMUK membership card: (And also specify its abbreviation in brackets)

WORK (OR STUDY) PLACE INFORMATION

Title:
Affiliation
Division / Department:
Street Address:

City, State, Zip:
Telephone:
Fax:
E-mail:

HOME ADDRESS, ETC...

Street Address:

City, State, Zip:	,	,
Telephone:
Fax:
E-mail:
Please my mail to:	Home	Work	Address

INDIVIDUAL MEMBERSHIP INFORMATION
AND ASSOCIATION RECORDS

(+)(FOR CORPORATE MEMBERSHIP DETAILS SEND E-MAIL TO [email protected])

I would like to join ITUMUK as
	a Regular Member Yearly dues $25. US (senelik aidat)
	a Student Member Yearly dues $10. US (senelik aidat)
	Initiation and ITUMUK ID (ilk giris ve kimlik ucreti) \| $10. US
	My check payable to ITUMUK is mailed.
	My picture for ITUMUK card is mailed.

Total:$ US(*):

(*) Sayet bir diger uye ile evli iseniz, sadece biriniz senelik aidat oder

(+) Note: Corporate membership provides passage to corporate homepage, and provides logo ICON in "TurkishNews.com" Business Section Homepage. And many other benefits, ask for details([email protected])

Payment could be made to (Bagisin yabilabilecegi ITUMUK banka hesaplari)

For Secure payment online please go to http://www.turkishnews.com/cgi-bin/payment.cgi
WEBSTER Bank, 1085 Main Street East Hartford, CT, USA
Rout No: 211170101-10 Account No: 8070355226
Or may be mailed in check or money order,or cash to Association Address
Or may be charged to Visa-MasterCard by sending the following:
Visa: MasterCard: Exp. Date:
Card Number:
Name As Written on the Card:
(Credit Card payments will be processed by "Turkish Promotion Fund" owned by ITUMUK.)

Lutfen banka makbuzlarinizi (veya iptalli ceklerinizi)ITUMUK Uluslararasi Kurulusu adresine posta veya faks (001-(860)-282-0251) ile ulastiriniz.Secure Server'dan yaptiginiz odemeler icin lutfen gelen makbuzu bize gonderin.

ITUMUK 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 Database), By General Assembly
6. Membership Drive (Mezunlara Tanitim)
7. Board of Trustees (See Bylaws for Req.) (Lutfen tuzugu inceleyin)
8. Young ITU (ITUMUK Genclik Kolu)
9. May Turkish Week Activities NewYork (19 Mayis Turk Haftasi)
10. Federation (FTAA) or Assembly (ATAA) Rep. (ITUMUK Temsilciligi)
11. Technical Conference Organization (Konferans Duzenleme)
12. Regional Meetings Organization (Bolgesel Toplantilar)
13. Regional Board of Directors (Bolgesel Idare Heyeti)
14. ITU Scientific Aid (ITU Lab. Malzemesi Ozel Yardim)
15. ITUMUK 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. ITUMUK WWW Homepage
21. ITUMUK E-Dergi PETEK
22. Other (onerdiginiz diger bir saha varmi)