SAE INDIA Collegiate Club Application

Information about the Institution College Name University Address 1 Address 2 City, State Pin Code College Web Page Faculty Advisor Information Name Title Department Address 1 Address 2 City, State Phone Email (required) Additional Faculty Advisor Information Name Title Department Address 1 Address 2 City, State Phone Email (required) Head of the Department Information Name Address 1 Address 2 City, State Pin Code Pin Code Fax Pin Code Fax

Phone Email

Fax

Which accreditation bodies have accredited your engineering programs? ABET ___________________________ ___________________________ Which engineering programs does your school offer? Aerospace Engineering Agricultural Engineering Architectural Engineering Bioengineering Biomedical Engineering Chemical Engineering Civil Engineering Computer Science Engineering Electrical Engineering Environmental Engineering Geo Environmental Engineering Industrial Engineering Manufacturing Engineering Mechanical Engineering Nuclear Engineering Mining Engineering Petroleum Engineering Other ____________________ Other ____________________ Other ____________________ ___________________________ ___________________________ ___________________________

All facilities will be provided to the SAE INDIA Collegiate Club in the Institution for carrying out the stated activities.

Signature of the Head of the Institution and Seal

Signature of HOD