professional membership application

Professional Membership Application AMERICAN SOCIETY OF MECHANICAL ENGINEERS

Instructions: Complete all applicable fields and mail with payment to: ASME, 22 Law Drive, P.O. Box 2900, Fairfield, NJ 07007-2900, or fax to: 1-973-882-1717. Applications without payment will not be processed. For assistance completing this application, please call 1-973-882-1167 or 1-800-THE-ASME, or email questions to [email protected].

You can also join online at: www.asme.org/membership

________________________________________________________________Last Name/Family Name

___________________________________ ___________ ______________First Name/Given Name Initial Gender

________________________________________________________________Birthdate MM / DD / YYYY (you must include exact birthdate with year)

________________________________________________________________Company

________________________________________________________________Primary (Mailing) Address Home Business

________________________________________________________________ (please attach additional sheet if more space is needed for address)

__________________________________ ___________ ________________City State/Province Country

___________________________ ___________________________________Zip/Postal Code Telephone Number (including area code)

___________________________________ ____________________________Email Address Fax Number (including area code)

Select a code based on your Principal Job Function

2014-2015 Membership Dues Schedule • Choose one:

___________________________________________________________ Credit Card Number

_____________________________________ ____________________ Exp. Date (MM/YY) Security Code (CSC/CVV2)

__________________________________________________________ Cardholder Name

___________________________________________________________ Cardholder Signature

Select a code that best describes your Title

Dues Payment Information • Payment by:

Check AmEx Visa Mastercard Discover Euro Card Money Order

1.No Degree 2.B.A. 3.B.E. 4.B.S. 5.M.A. 6.M.S. 7.M.E. 8. Ph.D. 9. Sc.D. 10.Other (Describe)____________

P.E.

Name of current employer

Job Title

Length of time in current job years: months:

College(s) / University(ies) AttendedCollege/University Location Degree Area of Study Date of Degree

Professional Engineering RegistrationState/Country License No. Date of Issue

Reference • Please complete to the best of your ability. Check box if your reference is an ASME Member

Name___________________________ Company____________________________

Address__________________________________ City________________________

State/Province_____________ Postal code____________ Country________________

Email _______________________________ Telephone________________________

Professional History

Professional Record (attach resume or curriculum vitae)

(A) I authorize the Society to verify the information contained in this application and, to that end, to contact any educational institution, professional society, publisher, employer, or otherentity named or identified in this application or in any document submitted in support of this application. I hereby consent to and authorize the release and disclosure to ASME of any information records or correspondence as required to verify the information in the application, which is held by any such entity identified in this application.

(B) I subscribe to the above and, if elected to any grade, will be governed by the Constitution and By-Laws of the Society and its Code of Ethics as long as I continue as a member. I furthermore agree to promote the objectives of the Society so far as shall be in my power.

01 General or corporate management02 Product design, including applied research and development03 Systems design, including applied research and development13 Design of equipment for in-plant use14 Other design engineering functions04 Production engineering (processing or manufacturing)05 Testing, reliability assurance, quality control, and standards06 Plant engineering, operations, and maintenance11 Basic research & development15 Other process engineering functions12 Consulting07 Education 08 Other-please specify:___________________________________________

Engineering31 Corporate V.P. for Engineering, Director, etc.32 Chief Engineer, Senior Engineer, etc.33 Project Manager34 Other (e.g. Engineer, Allied Scientist)

Non-Engineering35 President, Owner, etc.36 Vice President, Senior Manager, etc.37 Project Manager, Manager, or Supervisor38 Other (e.g., sales, marketing)

Please complete all sections on back side of application.

Member or Affiliate (see page 2 for definition). . . . . . . . . . . . . . . . $149 USD

Member within 1 year of graduation . . . . . . . . . . . . . . . . . . . . . . . . $ 59 USD

Member within 2 years of graduation . . . . . . . . . . . . . . . . . . . . . . . $ 81 USD

Member within 3 years of graduation . . . . . . . . . . . . . . . . . . . . . . . $104 USD


COUNTRIES ELIGIBLE FOR 50% DUES DISCOUNT COUNTRIES ELIGIBLE FOR 25% DUES DISCOUNT

6/2014

ASME 22 Law Drive, P.O. Box 2900, Fairfield, NJ 07007-2900

Phone: 973-882-1167 (Global) 800-THE-ASME/800-843-2763 (U.S./Canada)Fax: 973-882-1717 Email: [email protected]

M F

AFGHANISTANBANGLADESH BENINBHUTANBURKINA FASO BURUNDI CAMBODIA CENTRAL AFRICAN REPUBLICCHADCOMOROSCONGO, DEM. REP COTE D'IVOIREDJIBOUTIERITREAETHIOPIAGAMBIAGHANAGUINEAGUINEA - BISSAUHAITIINDIAKENYAKOREA, DEM. REP.KYRGYZ REPUBLICLAOSLIBERIA

MADAGASCARMALAWIMALIMAURITANIAMONGOLIAMOZAMBIQUEMYANMAR NEPALNIGERNIGERIA PAKISTANRWANDASENEGALSIERRA LEONESOLOMON ISLANDSSOMALIATAJIKISTANTANZANIATIMOR-LESTETOGOUGANDAUZBEKISTANVIETNAMYEMEN REPUBLICZAMBIAZIMBABWE

ALBANIAALGERIAANGOLAARMENIAAZERBIJANBELARUSBELIZEBOLIVIABOSNIA & HERZEGOVINABULGARIACAMEROONCAPE VERDECOLOMBIACONGO REP CROATIAECUADOREGYPT, ARAB REP.EL SALVADORFIJI GEORGIAGUATEMALA

GUYANAHONDURASINDONESIAIRANIRAQJAMAICAJORDANKAZAKHSTANKIRIBATIKOSOVO LAO PDR LESOTHOMALDIVESMARSHALL ISLANDSMICRONESIA, FED. STS.MOLDOVAMOROCCONAMIBIANICARAGUAPAPUA NEW GUINEAPARAGUAY

PEOPLES REP/CHINAPERUPHILIPPINESSAMOASAO TOME AND PRINCIPESERBIASOUTH SUDANSRI LANKASUDANSURINAMESWAZILANDSYRIAN ARAB REPUBLICTHAILANDTONGATUNISIATURKMENISTANTUVALUUKRAINEVANUATUWEST BANK AND GAZA

Residents of certain countries may be eligible for additional discounts. See second page for details.

Residents of South Dakota and Canada are required to calculate and add sales tax to their payment when paying by Check or Money Order.*

Sales tax will be added automatically when paying by Credit Card.

ASME Membership Dues $ ________________ * Sales Tax $ ________________ Total $ ________________

ASME Grades of Membership C3.1.5 A Member, at the time of admission or advancement to that grade, shall have attainments amounting to the equivalent of at least eight years of engineering experience.

C3.1.6 An Affiliate should be a person who is capable of and interested in rendering service to the field of engineering; and whose work should be so related to applications of engineering that admission to this grade will contribute to the welfare of the Society.Membership grades will be assigned based on information provided with this form. Additional information may be required for other grades.

(Note: A degree in an approved engineering curriculum or a baccalaureate degree in an approved engineering technology curriculum shall be accepted as equivalent to the eight-year experience requirement.)

What Interests You? • Choose up to eight:Connect with engineering professionals and participate in as many interest groups as you would like from the list below. ASME groups allow engineers and technical professional to receive relevant information and engage with others who share similar interests throughout the world. Indicate up to 8 selections. To become an online Participant in these and other groups beyond the available fields below, visit our website at www.asme.org/groups

27 Advanced Energy Systems

01 Aerospace

02 Applied Mechanics

42 ASME International Outreach

09 Bioengineering

31 Computers & Information in Engineering

14 Design Engineering

25 Dynamic Systems & Control

44 Early Career (Connect)

45 ECLIPSE

34 Electronic & Photonic Packaging

23 Environmental Engineering

47 Engineers Without Borders

48 Entrepreneur's Network

36 Fluid Power Systems & Technology

08 Fluids Engineering

46 Grad Students

11 Heat Transfer

38 Information Storage & Processing Systems

05 Internal Combustion Engine

22 Int’l Gas Turbine Institute

49 Latino Operacion y Mantenimiento de Calderas

03 Management

13 Manufacturing Engineering

10 Materials

29 Materials and Energy Recovery

04 Materials Handling Engineering

39 Microelectromechanical Systems

41 Nanotechnology Institute

32 Noise Control & Acoustics

33 Non-destructive Evaluation

17 Nuclear Engineering

35 Ocean, Offshore & Arctic Engineering

16 Petroleum

40 Pipeline Systems

21 Plant Engineering & Maintenance

19 Power

50 Pre-College

28 Pressure Vessels & Piping

12 Process Industries

18 Rail Transportation

07 Safety Engineering & Risk Analysis

30 Solar Energy

51 Student Liaisons

24 Technology & Society

15 Tribology

43 Women in Engineering

Personal Information • Complete all applicable fields:

mailto:[email protected]

http://www.asme.org/membership

http://www.asme.org/groups

Professional Membership Application AMERICAN SOCIETY OF MECHANICAL ENGINEERS

Instructions: Complete all applicable fields and mail with payment to: ASME, 22 Law Drive, P.O. Box 2900, Fairfield, NJ 07007-2900, or fax to: 1-973-882-1717. Applications without payment will not be processed. For assistance completing this application, please call 1-973-882-1167 or 1-800-THE-ASME, or email questions to [email protected].

You can also join online at: www.asme.org/membership

________________________________________________________________Last Name/Family Name

___________________________________ ___________ ______________First Name/Given Name Initial Gender

________________________________________________________________Birthdate MM / DD / YYYY (you must include exact birthdate with year)

________________________________________________________________Company

________________________________________________________________Primary (Mailing) Address Home Business

________________________________________________________________ (please attach additional sheet if more space is needed for address)

__________________________________ ___________ ________________City State/Province Country

___________________________ ___________________________________Zip/Postal Code Telephone Number (including area code)

___________________________________ ____________________________Email Address Fax Number (including area code)

Select a code based on your Principal Job Function

2014-2015 Membership Dues Schedule • Choose one:

___________________________________________________________ Credit Card Number

_____________________________________ ____________________ Exp. Date (MM/YY) Security Code (CSC/CVV2)

__________________________________________________________ Cardholder Name

___________________________________________________________ Cardholder Signature

Select a code that best describes your Title

Dues Payment Information • Payment by:

Check AmEx Visa Mastercard Discover Euro Card Money Order

1.No Degree 2.B.A. 3.B.E. 4.B.S. 5.M.A. 6.M.S. 7.M.E. 8. Ph.D. 9. Sc.D. 10.Other (Describe)____________

P.E.

Name of current employer

Job Title

Length of time in current job years: months:

College(s) / University(ies) AttendedCollege/University Location Degree Area of Study Date of Degree

Professional Engineering RegistrationState/Country License No. Date of Issue

Reference • Please complete to the best of your ability. Check box if your reference is an ASME Member

Name___________________________ Company____________________________

Address__________________________________ City________________________

State/Province_____________ Postal code____________ Country________________

Email _______________________________ Telephone________________________

Professional History

Professional Record (attach resume or curriculum vitae)

(A) I authorize the Society to verify the information contained in this application and, to that end, to contact any educational institution, professional society, publisher, employer, or otherentity named or identified in this application or in any document submitted in support of this application. I hereby consent to and authorize the release and disclosure to ASME of any information records or correspondence as required to verify the information in the application, which is held by any such entity identified in this application.

(B) I subscribe to the above and, if elected to any grade, will be governed by the Constitution and By-Laws of the Society and its Code of Ethics as long as I continue as a member. I furthermore agree to promote the objectives of the Society so far as shall be in my power.

01 General or corporate management02 Product design, including applied research and development03 Systems design, including applied research and development13 Design of equipment for in-plant use14 Other design engineering functions04 Production engineering (processing or manufacturing)05 Testing, reliability assurance, quality control, and standards06 Plant engineering, operations, and maintenance11 Basic research & development15 Other process engineering functions12 Consulting07 Education 08 Other-please specify:___________________________________________

Engineering31 Corporate V.P. for Engineering, Director, etc.32 Chief Engineer, Senior Engineer, etc.33 Project Manager34 Other (e.g. Engineer, Allied Scientist)

Non-Engineering35 President, Owner, etc.36 Vice President, Senior Manager, etc.37 Project Manager, Manager, or Supervisor38 Other (e.g., sales, marketing)

Please complete all sections on back side of application.

Member or Affiliate (see page 2 for definition). . . . . . . . . . . . . . . . $149 USD

Member within 1 year of graduation . . . . . . . . . . . . . . . . . . . . . . . . $ 59 USD

Member within 2 years of graduation . . . . . . . . . . . . . . . . . . . . . . . $ 81 USD



COUNTRIES ELIGIBLE FOR 50% DUES DISCOUNT COUNTRIES ELIGIBLE FOR 25% DUES DISCOUNT

6/2014

ASME 22 Law Drive, P.O. Box 2900, Fairfield, NJ 07007-2900

Phone: 973-882-1167 (Global) 800-THE-ASME/800-843-2763 (U.S./Canada)Fax: 973-882-1717 Email: [email protected]

M F

AFGHANISTANBANGLADESH BENINBHUTANBURKINA FASO BURUNDI CAMBODIA CENTRAL AFRICAN REPUBLICCHADCOMOROSCONGO, DEM. REP COTE D'IVOIREDJIBOUTIERITREAETHIOPIAGAMBIAGHANAGUINEAGUINEA - BISSAUHAITIINDIAKENYAKOREA, DEM. REP.KYRGYZ REPUBLICLAOSLIBERIA

MADAGASCARMALAWIMALIMAURITANIAMONGOLIAMOZAMBIQUEMYANMAR NEPALNIGERNIGERIA PAKISTANRWANDASENEGALSIERRA LEONESOLOMON ISLANDSSOMALIATAJIKISTANTANZANIATIMOR-LESTETOGOUGANDAUZBEKISTANVIETNAMYEMEN REPUBLICZAMBIAZIMBABWE

ALBANIAALGERIAANGOLAARMENIAAZERBIJANBELARUSBELIZEBOLIVIABOSNIA & HERZEGOVINABULGARIACAMEROONCAPE VERDECOLOMBIACONGO REP CROATIAECUADOREGYPT, ARAB REP.EL SALVADORFIJI GEORGIAGUATEMALA

GUYANAHONDURASINDONESIAIRANIRAQJAMAICAJORDANKAZAKHSTANKIRIBATIKOSOVO LAO PDR LESOTHOMALDIVESMARSHALL ISLANDSMICRONESIA, FED. STS.MOLDOVAMOROCCONAMIBIANICARAGUAPAPUA NEW GUINEAPARAGUAY

PEOPLES REP/CHINAPERUPHILIPPINESSAMOASAO TOME AND PRINCIPESERBIASOUTH SUDANSRI LANKASUDANSURINAMESWAZILANDSYRIAN ARAB REPUBLICTHAILANDTONGATUNISIATURKMENISTANTUVALUUKRAINEVANUATUWEST BANK AND GAZA

Residents of certain countries may be eligible for additional discounts. See second page for details.

Residents of South Dakota and Canada are required to calculate and add sales tax to their payment when paying by Check or Money Order.*

Sales tax will be added automatically when paying by Credit Card.

ASME Membership Dues $ ________________ * Sales Tax $ ________________ Total $ ________________

ASME Grades of Membership C3.1.5 A Member, at the time of admission or advancement to that grade, shall have attainments amounting to the equivalent of at least eight years of engineering experience.

C3.1.6 An Affiliate should be a person who is capable of and interested in rendering service to the field of engineering; and whose work should be so related to applications of engineering that admission to this grade will contribute to the welfare of the Society.Membership grades will be assigned based on information provided with this form. Additional information may be required for other grades.

(Note: A degree in an approved engineering curriculum or a baccalaureate degree in an approved engineering technology curriculum shall be accepted as equivalent to the eight-year experience requirement.)

What Interests You? • Choose up to eight:Connect with engineering professionals and participate in as many interest groups as you would like from the list below. ASME groups allow engineers and technical professional to receive relevant information and engage with others who share similar interests throughout the world. Indicate up to 8 selections. To become an online Participant in these and other groups beyond the available fields below, visit our website at www.asme.org/groups

27 Advanced Energy Systems

01 Aerospace

02 Applied Mechanics

42 ASME International Outreach

09 Bioengineering

31 Computers & Information in Engineering

14 Design Engineering

25 Dynamic Systems & Control

44 Early Career (Connect)

45 ECLIPSE

34 Electronic & Photonic Packaging

23 Environmental Engineering

47 Engineers Without Borders

48 Entrepreneur's Network

36 Fluid Power Systems & Technology

08 Fluids Engineering

46 Grad Students

11 Heat Transfer

38 Information Storage & Processing Systems

05 Internal Combustion Engine

22 Int’l Gas Turbine Institute

49 Latino Operacion y Mantenimiento de Calderas

03 Management

13 Manufacturing Engineering

10 Materials

29 Materials and Energy Recovery

04 Materials Handling Engineering

39 Microelectromechanical Systems

41 Nanotechnology Institute

32 Noise Control & Acoustics

33 Non-destructive Evaluation

17 Nuclear Engineering

35 Ocean, Offshore & Arctic Engineering

16 Petroleum

40 Pipeline Systems

21 Plant Engineering & Maintenance

19 Power

50 Pre-College

28 Pressure Vessels & Piping

12 Process Industries

18 Rail Transportation

07 Safety Engineering & Risk Analysis

30 Solar Energy

51 Student Liaisons

24 Technology & Society

15 Tribology

43 Women in Engineering

Personal Information • Complete all applicable fields:

mailto:[email protected]

professional membership application

Documents