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Apply for PES Membership Online....

APPLICATION FOR MEMBERSHIP

Name: Date of Birth:

Address1:

Address2:

City: State: Zip+4:

Phone: Fax: Email:

Employer: Title: Phone:

Bus. Address: City: State: Zipcode:

Education:

College Degree:
Year:

College Degree: Year:

College Degree: Year:

Other:

Special Engineerlng Awards/Achievements:

Other Professional Organization Memberships:

Other Special Activities/Interests:

Please check if you are a member in good standing of any of the societies listed below:

AFE
ASCE ASHRAE IES RISPE RISPLS SEARI SARI Other

Referred by P.E.S Member:

Names of 2 Additional Professional References:

Name: Name:
Organization: Organization:
Title: Title:

 Membership Level Desired: Member:   Associate: Applicant’s Signature_________________________

 Please submlt this application along with $15.00 Initiation Fee to:

Providence Engineering Society, c/o PARE Engineering Corp., Attn: John P. Shevlin, P. E., 8 Blackstone Valley Place, Lincoln, RI 02865