To become a NACE Member, complete the following Membership Application. Please complete this form and print out, then return it with payment to NACE.
Check One:
Membership Renewal
First Time Applicant
Application for:
Voting Membership, Open to any individual employed in an engineering or management capacity by a county or equivalent government agency (see Voting Members).
Associate Membership, Open to any individual whose education, training, vocation, or experience will further the goals and objectives of the organization. An associate member has all the rights and benefits of membership except holding office and voting (see Associate Members).
| Last Name: |
| First Name: |
Initial: |
| Title: |
| Employer: |
| Address: |
| City: |
State/Province: |
| Zip Code: |
| Phone: |
Fax: |
| E-Mail: |
| Nickname: |
| Spouse (first & last): |
| Home Address: |
| City: |
State/Province: |
| Zip Code: |
Phone: |
| Email: |
| States Registered P.E.: |
L.S.: |
| Other: |
Engineering Degree (y/n): |
| Years Experience: |
Years of County Eng: |
| Years of Management: |
Years in Present County: |
| Membership in Professional Societies: |
Referred By: |
Brief History of Experience:
____________________________________________________________________
Indicate responsibilities, check all that apply:
_____ Airports
_____ Drainage/Storm Water Management
_____ Highway Engineering
_____ Bridge Engineering
_____ Public Works Engineering
_____ Highway Construction
_____ Bridge Construction
_____ Public Works Management
_____ Highway Maintenance
_____ Bridge Maintenance
_____ Water/Sewer System
_____ Traffic Engineering
_____ Bridge Inspections
_____ Planning
_____ Emergency Management
_____ GIS/Surveying
_____ Solid Waste Management
Other:__________________________________________________________
Interested in serving on a NACE Committee?
Check any that you are interested in:
_____ Administration & Finance
_____ GIS/Surveying
_____ Solid Waste
_____ Storm water & Drainage
_____ Construction & Maintenance
_____ Structures
_____ Traffic
_____ Data & Information
_____ CD ROM
_____ Emergency Management
_____ Technology Transfer
_____ Corporate Programs
_____ Legislative
_____ Awards
_____ Constitution/By-Laws
_____ Nominating
Send NACE Mailings to: (check one) _____ Work or _____ Home
State Affiliate Member?* ______ If yes, State ________________
Payment Information:
_____ $130 Dues Enclosed
_____ $130 Bill Me
_____ $120 State Chapter Payment* (State Affiliate Members Only)
Applicant Signature & Date:
____________________________________________________________________
Mail completed form with payment to:
National Association of County Engineers
25 Mass. Ave NW, Suite 580
Washington, DC 20001
(202) 393-5041
If you have any questions or for further information, email NACE.