NACE INtErNAtIoNAl StudENt MEMbErShIp ApplICAtIoN

Transcription

NACE INtErNAtIoNAl StudENt MEMbErShIp ApplICAtIoN
N A C E I n t e r nat i o na l S t u d en t M em b e r s h i p A p p l icat i o n
To qualify for the student membership rate and benefits, you must meet the following criteria:
1. Be enrolled as a full-time student at an accredited university or college (12 hours undergraduate, 9 hours graduate or above).
2. Proof of full-time enrollment (course schedule, student ID) must be submitted with this form.
3. Seven years is the maximum length of time an individual can retain student status.
4. Student eligibility must be reviewed annually.
Please note address changes and check the appropriate “college” or “home” box. Indicate alternate address, phone, and fax numbers.
New
Renewal
Change
PERSONAL & COMPANY DATA
Please complete both your college and home addresses. Where do you want information mailed?
College or University
Home
First Name:
Last (Family) Name:
College Name:
College Address:
(Include mail stop)
City:
State/Province:
Zip/Postal Code:
Country:
College Phone:
(Include area code for U.S. and country/city codes for international)
Fax:
(Include area code for U.S. and country/city codes for international)
E-mail:
Web Address:
Home Address:
(Include mail stop)
City:
State/Province:
Zip/Postal Code:
Country:
Home Phone:
Have you been a member of NACE previously?
(Include area code for U.S. and country/city codes for international)
Yes
No
If yes, NACE member #
PROFESSIONAL INTERESTS
A Sex:
□ Male □ Female
B Degree currently working to attain (REQUIRED):
A
□Associate’s
B
□Bachelor’s
M
□ Master’s
D
□ Doctoral
P
□ Post-doctoral
D How did you hear about NACE?
C
□ Colleague
A
□ Advertisement
E
□ Education Course
I
□ Internet
1
□ NACE Catalog
2
□ NACE Journal
0
□ Other_______________________________
(please specify)
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G From the list below, choose the classification that best
describes your career interests. (Choose only one)
5
□ Engineering/Architecture/Consulting Firms
6
□ Research Services
7
□ Chemical Processing/Process Industries
& Allied Products
8
□ Aerospace
9
□ Pulp & Paper
11
□ Construction
12
□ Testing Services
13
□ Oil & Gas Extraction
14
□ Original Equipment Manufacturer
18
□ Coating & Lining Application
19
□ Coating & Lining Manufacturer/Distributor
21
□ Plastics/Nonmetals
23
□ Measuring, Analyzing & Controlling
Instrumentation
27
□ Railcar/Tank Trucks
50 □ Metals/Mining
51 □ Ships/Marine Structures/Offshore Platforms
52 □ Oil & Gas Pipelines/Storage Tanks
53 □ Refining
54 □ Power Plant/Electric Utility
55 □ Bridges & Highways
56 □ Municipal Water Distribution/Treatment
57 □ Industrial Water Treatment
140 □ Other_______________________________
(please specify)
I Birthdate
________ / ________ / ________
(REQUIRED)MM
DD
YY
N A C E I n t e r nat i o na l S t u d en t M em b e r s h i p A p p l icat i o n
To qualify for the student membership rate and benefits, you must meet the following criteria:
1. Be enrolled as a full-time student at an accredited university or college (12 hours undergraduate, 9 hours graduate or above).
2. Proof of full-time enrollment (course schedule, student ID) must be submitted with this form.
3. Seven years is the maximum length of time an individual can retain student status.
4. Student eligibility must be reviewed annually.
Failure to submit proper documentation will result in the delay of
processing your student membership application.
OPTIONS OF MEMBERSHIP AND SERVICES
AMOUNT
TOTAL
1 YEAR
FREE 120-Day Trial Student Membership (Only eligible to first-time student members,
some restrictions may apply.)
FREE
Student Membership (includes online access to Materials Performance and Corrosion journal)
$20
Materials Performance Subscription
Hard copy
$60
Corrosion Journal Subscription
Hard copy
$60
Membership Certificate
$15
FREE
Overseas Mail Option (available with paid subscription only—not valid in U.S., Canada, and Mexico)
Journals are sent via surface mail unless an airmail option is selected at an additional charge
h Materials Performance—12 issues
h Corrosion journal—12 issues
$35
$35
Add dues and options to calculate total amount to be paid.
Amount paid
Membership dues are nontransferable and nonrefundable. Membership benefits are nontransferable.
PAYMENT OPTIONS
Payments can be made by check, money order, or credit card in U.S. funds made payable to NACE.
Check number:
h Check/money enclosed: U.S. $
h Credit card payment
h MasterCard
h VISA
h American Express
h Discover
Account number:
Expiration date:
Name as it appears on card:
Signature:
For more information, contact NACE FirstService at 1 800-797-NACE (6223) (U.S. & Canada) or +1 281-228-6223 (Worldwide).
Mail completed application
with payment to:
NACE International
1440 South Creek Dr.
Houston, TX 77084-4906
USA
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