Barratt House, Kingsthorpe Road, Northampton NN2 6EZ

TEL: +44 (0) 1604 438222

E-mail: admin@icorr.org Web site: http://www.icorr.org
APPLICATION FOR STUDENT MEMBERSHIP
(Please TYPE or PRINT in black ink as this form will be photocopied)

SURNAME Mr/Mrs/Miss/Ms/Dr/Prof Mr FORENAMES (in full) Muhammad Osama Shuaib

Date Of Birth 08/12/1986
PRIVATE ADDRESS Building 35, Damascus Road, Al Qusais
including postcode Dubai, U.A.E.
P.O. Box: 20482
UNIVERSITY Cornerstone College (University of Wolverhampton Date Of Joining Mar-2017
COURSE Master in Business Administration
QUALIFICATIONS Bachelors of Science in Electrical Engineering
UNIVERSITY ADDRESS
Including postcode

Home +971504669644 Business +971521761580

TELEPHONE
Mobile +971504669644 Email mshuaib@protonmail.com
Email (for correspondence) mshuaib@protonmail.com
Which Address Do You Want To Use For Correspondence And The Journal Home

You are welcome to participate in the activities of any Branch and Division and for mailing purposes, you will be allocated to the
Branch covering your home location unless requested otherwise. Which Branch and Division do you wish to join? (please indicate)
North
Branch: Aberdeen London North West Yorkshire Midlands
East
Division(s) Corrosion Engineering Corrosion Science Young ICorr

DECLARATION (to be signed by all applicants)

I hereby confirm that I have an interest un the practice of corrosion technology and/or science and undertake to comply with the
Institute’s Articles of Association and Bye-laws.

Signed: .................................................................................................... Date:

……………………………….........................

FEES: Bone-fide full-time students are eligible for ICorr membership at no cost

To qualify for the ICorr student membership rate and benefits, you must:

1. Show proof (e.g. course schedule and student ID) of enrolment as a full-time student at an approved science or
engineering based study programme.

2. Submit proof of student eligibility on an annual basis at renewal. (Seven years is the maximum length of time an individual
may retain student status.)

Registered office as above. A company limited by guarantee and registered in England No 1240103. Registered Charity No 275206