Please complete all sections of the form.

Once completed, please save a copy and submit this form via email to: membershipapps@cibse.org AND print and post one copy to: Membership Department, CIBSE, 222 Balham High Road, SW12 9BS, UK.

APPLICATION FOR MEMBER/

FELLOW MEMBERSHIP
Please complete all sections of this application form and ensure
that copies of qualification certificates, signed by your sponsor,
and your CV, Engineering Practice Report, Organisational
Chart, Development Action Plan are attached and the required
payment is included. Please do not bind or staple documents.

REASON FOR JOINING

What prompted you to submit this application? Select ONE only:
Received a CIBSE mailing/Email/Newsletter
Advised by colleague/employer/CIBSE member
Attended a CIBSE membership briefing session

APPLICATION FOR MEMBER/FELLOW MEMBERSHIP

Found information on CIBSE website

Please indicate whether:

Attended a CIBSE event/exhibition

New (not previously a member of CIBSE) or,

Saw article/advert in industry publication

Transfer (already CIBSE member)

Saw information on Twitter/Linkedin

Grade Affiliate

Membership Number 046092

Y Have you previously applied to join CIBSE? (state Y/N in the box)
Please tick if already Interim or CEng registered
Please provide registration number and the Institution through
which you are registered:

PERSONAL DETAILS
Title Mr

Other (please specify)

EMPLOYMENT DETAILS
Please submit your curriculum vitae, in chronological order,
providing full details of your work experience within the field of
building services engineering: with full details of the companies
you have worked for, the posts you have held, and level of
responsibility.
ENGINEERING PRACTICE REPORT

First Name(s) Mohammed Zakeer

Surname Kamalapur
Date of Birth 01
D D / 06
M M / 83
YY
Home address S/O Mohammed Anver, Cycle Dealers

Jamiya Complex, Islampur , Gangavathi

Post code 583227

St: Karnataka Dt: Koppal

Country India

Please submit an Engineering Practice Report (EPR) of

between 4000 to 5000 words. Your Report should be based on
the Competence Criteria for MCIBSE or FCIBSE(fact sheet M21/
F21). For advice on how to write an EPR please refer to the
Application Guidance for MCIBSE or FCIBSE (fact sheet M20/F20)
and review exemplar reports at www.cibse.org/applicanthelp
ORGANISATIONAL CHART
Please submit an organisational chart indicating your position in
the organisation.

Telephone No 0091-7760099475
Fax No

DEVELOPMENT ACTION PLAN

Email mdzakeers@gmail.com

Please submit a statement of how you intend to continue with

your personal and professional development, stating your short,
medium and long term goals and your intended actions to attain
those goals.

Mobile No 00966536403716
Company name Al Hamdan Consulting Office
Work address Energy Center Building

MAIN ENGINEERING DISCIPLINE

Near DHL

Al Khobar
Country Saudi Arabia

Post code 31952

Please indicate from the list below your main area of expertise
in building services engineering. This information will assist CIBSE
in allocating an appropriate assessor to appraise your application.

Telephone No +966- 0138943981

Academia

Electrical

Fax No ahmed.yussuf@aecom.com

Energy Management

Environmental

Email consult@hamdanconsult.com

Facilities Management

M & E

Preferred mailing address

Home

Work

Preferred email address

Home

Work

APPLICATION FOR MEMBER/FELLOW MEMBERSHIP

Mechanical

Public Health

Other (please specify)

Page 1 of 4

SPONSORS DECLARATION
Please provide one sponsor, who can be a professionally qualified
Member (MCIBSE) or Fellow (FCIBSE) of CIBSE, a CEng registrant
with any Engineering Council nominated institution or professionally
registered within the construction industry. Your sponsor should have
known you for a minimum of one year. For further details of the role
of the sponsor please see the Application Guidance for MCIBSE
or FCIBSE (fact sheet M20/F20). NB. Sponsors may be contacted
by CIBSE for confirmation of their support of the applicant.

Date of Birth 07
DD / M
YY
07M / 54
Signature Date

DD / MM / YY

To the best of my knowledge, all the information contained in

this application and supporting documents is correct.

CIBSE membership No (if applicable)

I confirm my support for this application at the grade applied for

years. I consider that
and have known the applicant for 2
the candidate is competent in A-E criteria and I have carefully
read the sponsor guidance in the factsheet M20.
I confirm that I am:
Professionally qualified CIBSE member

Sponsors Institution Membership (if applicable):

Name of Institution: Institution of Mechanical Engineers
EngC registration grade/registration number 74711146
*If you are professionally registered with a non-Engineering Council nominated
institution, please send a copy of your registration certificate with this application.

INTERVIEW LOCATION
Please tick your preferred interview location and we will take this
into account when arranging your interview.
North West

South West

London and South East

North East

Scotland

East Midlands

Name of sponsor Ahmed Yussuf

West Midlands

Yorkshire

Home address

Wales

Northern Ireland

Republic of Ireland

Hong Kong

CEng registrant
Professionally registered within the construction industry*

Post code
Country
Telephone No

Australia
Qatar

United Arab Emirates

New Zealand

If you have any special requirements please let us know

Email ahmed.yussuf@aecom.com
DEMONSTRATION OF COMPETENCIES (MCIBSE/FCIBSE/CEng) TO BE COMPLETED BY THE SPONSOR
Please indicate below how the applicant has demonstrated, through your experience, the levels of competence required, as set in the
UK-SPEC, relative to the grade of membership and/or registration for which the applicant is applying.
A Use a combination of general and specialist engineering knowledge and understanding to optimise the application
of existing and emerging technology

Halliburton Saihat expansion was originally designed without much consideration being given to Building
Management Systems (BMS). This system would include the controls of the HVAC system (District Cooling in our
case) which are very important in terms of not only operations and maintenance purpose but also for the
environment.
Mohamed was charged to propose control system that will give the Client the benefit of running the District
Cooling System efficiently and also environmentally acceptable and compliant with both local and international
requirement.
Mohamed came up with a state of the art control system which included specialist software, Variable Frequency
Drives and other modern temperature and chilled water regulating elements.
Due its working and cost effectiveness Mohameds proposal was adopted and implemented and the entire
system is supplying all buildings with an all year round constant temperature.
B Apply appropriate theoretical and practical methods to the analysis and solution of engineering problems
I have known Mohammed for about two years working with me in Halliburton Saihat Project which comprises of
industrial workshops as well as 4-Star hotel.
In the original design of the project, the sewage system of the entire project was designed to be gravity fed
system. However, at the beginning of the construction period, the client, Halliburton, made a decision to procure
and install a fairly large Sewage Treatment Plant to which all the sewage from the entire base will be fed to.
It was found out later that the sewage treatment plant and all associated lifting stations were at higher level than
the sewage proposed for the Saihat Expansion Project making it impossible for our system to flow without
pumping.
To make sure that the two systems can be interfaced, Mohammed was assigned to come up with a proposal as
to how the two systems can be linked without having major impact on the project delivery schedules and cost.
Using his design experience and problem solving abilities he came with a viable proposal where our system had
to be made forced system. He introduced a number of small lifting stations dotted around the buildings. These
lifting were designed to feed the main central lifting station which is connected to STP. His proposed lifting
stations were unique in that we managed to avoid hitting water table which was a major issue for us.
APPLICATION FOR MEMBER/FELLOW MEMBERSHIP
Page 2 of 4
The entire sewage system in the base is now connected and functioning without any major problems.

DEMONSTRATION OF COMPETENCIES (MCIBSE/FCIBSE/CEng) TO BE COMPLETED BY THE SPONSOR (CONTINUED)

C Provide technical and commercial leadership

Throughout the project, Mohammed has been instrumental in deciding and solving many commercial issues. It is
very difficult to mention a single Mechanical variation that he has not played an important role.
For example, , both of the above cases required Mohammed not to only to be involved but also lead each case.
Even at this stage of the project where we are concluding variations and other commercial of the project
Mohammed is playing a leading role and there is hardly any Mechanical variation agreed with out his input.

D Demonstrate effective interpersonal skills

During the period that I have known Mohammed, I found him very confident communicator both written and
verbal. He produces weekly and monthly reports that are well structured and easy to understand and follow.
His interpersonal skills are excellent. He gets on very well with both colleagues and client. When presented with
challenges, Mohammed sells his ideas to others convincingly and often ends up persuading them.

E Demonstrate a personal commitment to professional standards, recognising obligations to society, the profession and
the environment

Over the two year period that I have worked with Mohammed, he has undertaken all his duties with great
professionalism and integrity. He adheres to the standards and allows no deviation from best practice.
For instance, a recent exercise Mohammed was assigned to ensure that all area of the project and various rooms
were complaint with regulatory requirement such NFPA and local Government regulations. He has undertaken
the work meticulously and resulted in Local Government permit being awarded.

EDUCATIONAL QUALIFICATIONS
Please list all your post school qualifications below and indicate any exemptions granted and details of any interruptions to your course.
Awards shown must be accompanied by a photocopy of the original certificate countersigned by your Sponsor as having seen the original.
University or
College

Full title of qualifications

gained including
subject area

Date course
commenced

Course
duration

Date
qualification
obtained

Mode of Study
(F/T, P/T, sandwich,
etc.)

Year of entry
to course

(i.e entered in year 1 or

2, 3 due to exemptions)

Singhania
University,Rajasthan
India

Master of Technology in
Mechanical (Thermal)
Engineering

August 2010

2 years

September
2012

P/T

Not Applicable

Visvesvaraya
Technological
University, Belgaum,
India

Bachelor of Engineering in
Mechanical

June 2005

May 2008

June 2008

F/T

T.M.A.E'S Polytechnic
Hospet, India

Diploma in Engineering
(Automobile)

May 2003

May 2005

June 2005

F/T

Not Applicable

APPLICANTS DECLARATION
I certify that the information in this application and supporting
documents is correct. I agree that, in the event of my election to
any class of membership of the Chartered Institution of Building
Services Engineers, I will be governed by the provisions of the
Royal Charter and By-laws as they are now formed or as they may
be hereafter altered; that I agree to abide by the Code of
Professional Conduct, which can be found at www.cibse.org/code,
and do all in my power to advance the objects of the Institution;
providing that whenever I shall signify in writing to the Director
of Membership that I wish to withdraw from the Institution,
APPLICATION FOR MEMBER/FELLOW MEMBERSHIP

I shall, after payment of any arrears which may be due by me

at that period, be free from this obligation.
Signature Date

D D / 10
M M / 14
YY
09

NB. In the event of it coming to light that information supplied on this form is inaccurate,
CIBSE reserve the right to withdraw membership of the Institution and discipline the
applicant under the Code of Professional Conduct.

Page 3 of 4

FEES
Please visit www.cibse.org/fees for details of all subscription,
application, interview and Engineering Council fees.

Payment can be made by cheque payable to CIBSE or by completing

the debit/credit card details below:

All new members must include payment for the following:

Application fee (if not already a CIBSE Member)
Interview fee
Annual Subscription fee for MCIBSE / FCIBSE
Engineering council CEng registration fee (if applicable)

Please tick:
Mastercard

All subscription fees run on an annual basis from 1st January to 31st December each
year. If you have already paid the annual subscription for another grade, the difference
between this rate and the new grade rate is payable when your membership is confirmed.
Fees are not dependent on date of joining and therefore not prorated. All application fees
are non refundable.

Credit Card Payers


Your application and interview fee will be debited
on receipt of your application.
Your subscription fee and engineering council fees
(if applicable) will be debited when your application
has been approved.

Visa

Visa/Delta

Maestro

Please note: we do not accept Amex or laser cards

Card Number

4 5 0 8 2 4 9 9 9 0
Valid from 05
M M / 14
YY
Issue Number (For Maestro only)

4 6 5 4 5 4

Expiry Date 05
M M / 17
YY

Security Code 2 2

Mechanical Engineer, Al Hamdan Consulting Office

Al Khobar
Country Saudi Arabia

Post code 31952

Please debit card to the amount of 100

Signature of Cardholder

Date

D D / 10
M M / 14
YY
09

DATA PROTECTION

SUBMITTING YOUR APPLICATION:

The information you provide in this application form will

be used by CIBSE and its regions or administrative agents
for administrative and membership purposes or as required
by law. We will use your information to keep you up to date
with news and developments in the industry, via email
and post.

Please post one hard copy and one email copy of your
application and supporting documents.

We do not sell lists of our members, but may pass your details on
to CIBSE regions acting on CIBSEs behalf as well as third parties
who work with CIBSE closely. If you do not wish to receive
mailings or emails from CIBSE please opt out below:
I do not wish to receive mailings from CIBSE
I do not wish to receive emails from CIBSE

Address details card is registered to Mohammed Zakeer

PLEASE POST ONE COPY OF YOUR APPLICATION TO:

Membership Department
Chartered Institution of Building Services Engineers
222 Balham High Road, London, SW12 9BS, UK
Registered Charity No. 278104
AND PLEASE EMAIL ONE COPY OF YOUR APPLICATION TO:
membership-apps@cibse.org
Telephone +44 (0)20 8772 3650 | Fax +44 (0)20 8675 5449
CIBSE HQ USE ONLY:

I do not wish to receive mailings (including emails) from

third parties approved by CIBSE relating to products and
services that are relevant to my membership.
CIBSE seeks to provide the best possible support to candidates.
From time to time, we use applicants material to illustrate
best practice. All material is anonymised. If you do not wish
your application to be used for this purpose, please tick here

APPLICATION FOR MEMBER/FELLOW MEMBERSHIP

Page 4 of 4