Student Membership Application



 Required Fields*
APPLICATION FOR: Student Membership Student Reinstatement
PERSONAL INFORMATION
First Name*

Last Name*

E-Mail*
 Middle Name

Birthdate*

Personal URL
PERMANENT ADDRESS (Home/Parents Address)
Street Address*

City*
 Home Telephone Number (Area Code/Number)*

State/Province*

ZIP/Postal Code*

Country*
ADDRESS AT SCHOOL (temporary personal address while at school)
School Attending*

Your Address at School *

City*

School URL

Name of Professor*


Indicate Mailing Preference: School Home		 Your Cell Phone Number (Area Code/Number)*

State/Province/Country*

Country*

ZIP/Postal Code*

Your school email address

Country of Citizenship
EDUCATION/DEGREE INFORMATION
COLLEGE OR UNIVERSITY & LOCATION
(must be seeking at least 1 degree)		 DEPARTMENT DEGREE GRADUATION DATE
(mm/yy)



*
 
 
CONTRIBUTIONS, LICENSES AND MEMBERSHIPS
Describe significant contributions in your field, such as important projects, major contributions to periodicals, publications, honors, awards, membership in honorary societies and participation on committees, etc.
PROFESSIONAL LICENSES (State of Registry and Type)
MEMBER OF FOLLOWING SOCIETIES
RINA
IME
NECI		 ASME
ASCE
AIChE		 AIAA
ASNE
IEEE		 NSPE
STUDENT DUES

$35.00 PER YEAR ANNUAL DUES

September 1st - August 31 next year:        $35.00

METHOD OF PAYMENT
Pay now with credit card

MasterCard VISA American Express

Account Number    Security Code   Expiration Date

APPLICANT'S SIGNATURE
I certify that the statements made in this application are correct. By submitting this application electronically I pledge to abide by the Bylaws of the Society and the Society's Code of Ethics.

 

If you have any questions regarding student registration, contact Fred Goldfarb.

IMPORTANT NOTE: Membership applications are processed at SNAME Headquarters. You will receive your member ID# as soon as your application is reviewed. Should you need immediate access to any "Members Only" options, please contact Edith Nowak for assistance.