2017-2018 Membership Application - Please Print Clearly

2017-2018 Membership Application - please print clearly

Application Date: Applicant Name: Company Name: Street Address: City, state and zip code: Phone number(s) E-mail address (required to receive information about events – print clearly):

Engineering School(s):

I am a Registered PE EIT/FE Academic Student

Firm Membership (up to three registered professional engineers may join): Firm Membership with Sponsorship: ($1525) Firm memberships are limited to companies that practice structural engineering or have structural engineering departments. Member firms will be listed on the DVASE website, and recognized on signage at all breakfast seminars. Attach membership forms for up to three (3) structural engineering practitioners with active professional registration (see Firm Affiliate below for additional members). In addition, the Member firm will receive a full hole sponsorship with 4 golfers for the annual golf outing.  Firm Membership: ($750) Standard Firm membership as above without sponsorship and golf. OR Individual Membership (select one of the eight types): Firm Affiliate: ($150) Additional individual structural practitioners with a member firm; Structural Engineer Practitioner: ($200) Individual structural engineer who is not with a member firm; Public Owner Practitioner: ($125) An employee of federal, state, local, or utility agency; Associate Member: ($125) Individual who is not yet a P.E., but has received a bachelor’s degree in structural, civil or architectural engineering; Retired Member: ($100) Retired structural engineers; Academic Member: ($75) Full-time faculty teaching in a structural engineering-related degree program at an accredited college/university; or Student Member: ($25) Full-time student enrolled in a structural engineering-related degree program at an accredited college/university. Affiliate Member: ($250) Does not qualify in any of the categories listed above. All DVASE Memberships include membership in the Structural Engineers Association of Pennsylvania (SEAoP) and the National Council of Structural Engineers Associations (NCSEA), and a subscription to Structures magazine.

Please check this box if you are interested in volunteering for DVASE. Please fill in with breakfast seminar and May dinner speaker suggestions, or any comments:

Application/renewal payments received after May 31st will be applied to the following season. PayPal payment is available. Please click on the link sent to you via email. If you have questions, call the DVASE office at 215-628-9844. If paying by check, make payable to DVASE and send the completed form with your membership fee to: DVASE Membership, 1231 Highland Avenue, Ft. Washington, PA 19034. Visit www.DVASE.org for additional information, or email [email protected].