ASNE Membership Application

This form may be completed on-line, then printed locally and submitted by mail or fax.

Date
I hereby apply for (Check one) . .
 
Member   Associate Member
Age 30 and over - $110
Under 30 - $50
Spouse Member  - $20
ASNE/SNAME Student Member - $35
  (For Student Mbrs)  Grad Date:  
  Degree Program 
$18.00 added for framed certificate with seal.
 Check Method of Payment:
Check enclosed $ or
Mastercard VISA AmExp DISC
 Credit Card #  
 Expiration Date MM/YY
 
Signature (as shown on Credit Card)

Name:
Last, First, Middle Initial
e-mail:
MILITARY ONLY
Rank
Service
Active Retired

Preferred Address for mailings: Home Office

HOME ADDRESS:

OFFICE ADDRESS:

(Street)
 FIRM or SCHOOL or ACTIVITY
(City) (State) (ZIP Code) + 4
PRESENT POSITION
Home Phone
Cell Phone
 (Street)
BIRTH DATE:
(Month / Day / Year) 		(City) (State or Country) (ZIP Code) + 4
(Optional)
Spouse's name: 		(Work Phone)
 Work Fax

Education:

Degree
Institution
Grad Year
ENGINEERING SPECIALTY:
Naval Engineering Experience: (Military & Civilian)

   
Recommending Member's Signature
Applicant's Signature
 
       SECTION CREDIT 
Recommending Member (Print Name)           (If applicable)   Name of Section
Make check payable to: "ASNE". Mail to:
American Society of Naval Engineers
Attention: Membership
1452 Duke Street, Alexandria, VA 22314-3458
 Fax (703) 836-7491
Tel (703) 836-6727
e-mail membership@navalengineers.org

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http://www.navalengineers.org | Updated January 16, 2002
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