Membership : Application
Please complete the form below in its entirety to submit your membership application.
Click here to download a printable version of this form.
Section I
*
Firm Name:
Parent company if branch or subsidiary:
*
Address 1:
Address 2:
*
City:
*
State:
*
Zip:
*
Phone:
Fax:
Website:
Total Company-wide Personnel:
Total State Personnel:
Business Organization Type:
Cooperative
Joint Venture
Corporation
Limited Partnership
Sub Chapter S
Limited Liability Company (LLC)
Public
Partnership
Private
Sole Proprietorship
Firm Description:
Briefly describe the firm's activities.
Minority Status:
Certified Small Business
Service Disabled Veteran Owned Business
Disadvantaged Business Enterprise
Women's Business Enterprise
Minority Business Enterprise
Disciplines Offered:
For statistical purposes, indicate which of the following disciplines are provided by the firm. Include only in-house capabilities by virtue of experience and having a principal registered in the specific field.
Agricultural/Biological Engineering
Geotechnical
Architectural
Hydrology
Chemical
Industrial
Civil – General
Land
Civil – Structural
Development
Civil – Transportation
Marine & Coastal
Computer/Communications/Systems
Mechanical
Construction Management
Mining/Materials
Electrical
Nuclear/Petroleum/Energy
Environmental
Planning
Fire/Earthquake/Hazards/Safety
Surveying/GIS/Mapping
Forensic
Water/Wastewater
Other
Section II
Key Principal or Primary Contact (Required)
*
Full Name:
*
Title:
*
Email Address:
*
Professional Role Within Firm:
Roster for Staff Participation in ACEC
Add the names of staff members whom you feel would benefit from participation in ACEC. Your firm's ROI on your ACEC membership is directly related to the number of staff who are active in the Council.
STAY IN TOUCH WITH THE ENGINEERING COMMUNITY
All Staff Members added to this roster will receive
Last Word
and
Engineering Inc.
Staff Member staffMemberNumber
Full Name:
Title:
Email Address:
Professional Role Within Firm:
Staff Member 1
Full Name:
Title:
Email Address:
Professional Role Within Firm:
Staff Member 2
Full Name:
Title:
Email Address:
Professional Role Within Firm:
Staff Member 3
Full Name:
Title:
Email Address:
Professional Role Within Firm:
Staff Member 4
Full Name:
Title:
Email Address:
Professional Role Within Firm:
+ Add Another Staff Member
ACEC-NH c/o Dennehy & Bouley | 6 Hills Ave, Ste B | Concord, NH 03301
P: 603.225.7397 | E: | F: 603.228.6771
Copyright © 2002-2012 American Council of Engineering Companies - New Hampshire
Made, Maintained & Powered in USA by
CrystalVision
