American Council of Engineering Companies - New Hampshire : Membership : Application

Date:

Year Firm Founded/Organized:

Type of Membership for which you are applying :

Full:

Associate:

Name of firm:

Street Address:

Mailing Address (if different):

City:

State:

Zip+4:

Telephone:

Fax: Email:

Is this a branch office or a subsidiary?

yes (if yes, see below)

Ownership:

Privately-owned

Partnership

Corporation

Publicly - Held Stock

Sole Proprietorship

Subsidiary of:

Firm

Address

If this is a subsidiary firm owned by a parent firm, please see Section 3 of the bylaws on this application (page 4).

Fields of practice:

Architectural

Civil, Environmental

Civil, General - Municipal

Civil, Geotechnical

Civil, Structural

Electrical

Engineering Technology

Environmental Science

Landscape Architecture

Planning

If applying for associate

Membership, please specify

other fields of practice:

Principals, Partners or Officers:

Name:

Title:

Registration - State, Type, Number:

Professional or Technical Organizations to which Firm or its Principals belong:

	Yes	No
Is your firm in the independent professional practice of consulting engineering?
Is your firm engaged principally in the independent professional practice of design professional services?
Do your firm's principals hold registrations or certifications in good standing in the states where the offices are maintained?
Do your firm and its principals have financial or other connections with any commercial, sales or contracting interests or other affiliations which might conflict with or subordinate independent professional judgment? (if yes, please attach explanation)

Services Provided by Firm:

Describe services, areas in which your firm practices and/or types of clients (50 words or less).

Total Number of Personnel in all offices (average total of principals and all employees):

Number of Personnel in NH offices (average total of principals and all employees):

Name of Principals who will be the official firm representative to ACEC-NH and receive primary correspondence:

References:

Please furnish the names and address of three consulting/professional design forms (preferably two of which belong to ACEC-NH) together with the name of of the principal officer of each who is familiar with the work your firm performs.

Firm Name

Address - Street

City State Zip

Name of Principal Officer

Telephone

Firm Name

Address - Street

City State Zip

Name of Principal Officer

Telephone

Firm Name

Address - Street

City State Zip

Name of Principal Officer

Telephone

EXCERPTS FROM THE BYLAWS OF ACEC-NH

ARTICLE II - MEMBERSHIP

Section 2. Classes of Membership.

The classes of Membership of the council shall have the qualifications described below.

Member Firms shall be limited to those Member Firms, parent firms, branch offices, divisions or subsidiaries whose resident principals (proprietors, partners, officers or responsible authority) furnish independent consulting engineering services in accordance with state of New Hampshire Statutes, and shall

maintain established offices in New Hampshire for the practice of consulting engineering, as (i) sole proprietorships; (ii) as partnerships; or (iii) as corporations or divisions or subsidiaries furnishing consulting engineering services provided that their officers act for them on professional policies and activities.
have one or more principals or a person of responsible authority registered or licensed professionally in accordance with the laws of the State of New Hampshire;
belong to the American Consulting Engineers Council;
practice consulting engineering in accordance with the ACEC Professional and Ethical Conduct Guidelines;
practice under an organizational arrangement that does not involve a conflict of interest or does not subordinate independent professional judgment to other considerations. Firms or corporations, wholly or partially owned by commercial, or construction contracting, manufacturing, sales, public utility, holding company or other similar organizations which function as service organizations for the controlling company, shall not be eligible for membership if such ownership arrangements prejudice or subordinate the professional or ethical judgment of the professional engineers.

Associate Members. An Associate Member category may be created and maintained by ACEC-NH. This Associate Member category shall be in accordance with the eligibility requirements of this section, and any other applicable criteria established by ACEC-NH. Only firms judged not eligible for ACEC or ACEC-NH membership as a "Member Firm" are eligible to become Associate Members. Associate Members shall not be eligible to vote on ACEC-NH business, hold office in ACEC-NH, nor serve as a chairperson of a ACEC-NH committee.

Associate Members shall be limited to those sole proprietors, firms, parent firms, branch offices, subsidiaries, and/or organizations that provide professional services of a scientific and technical nature that are complementary to the services provided by Member Firms. Such members shall not include entities that supply goods or services that are specified by or used in the operations of consulting engineers.

Section 4. Representatives of Member Firms.

Each Member Firm shall designate the individual to serve as its official representative to ACEC-NH, and a second individual (provided there is more than one principal or responsible authority in the firm) to serve as an alternate. An official representative or alternate shall be a principal of the Member Firm (or the responsible authority of a branch office of a firm that is not headquartered in New Hampshire, who is not a principal).

Section 5. Representatives of Associate Members.

An associate member shall be permitted up to two representatives to ACEC-NH one of whom will be the principal or responsible authority of the firm. These representatives will not serve as a ACEC-NH Officer or Director, or Committee Chairperson. He or she may attend and participate in all ACEC-NH activities. The representative shall serve without voting capacity, as an advisor only.

By submitting this form, I (we) have read the qualifications for membership in the Consulting Engineers of New Hampshire, Inc. and believe that our firm meets the necessary requirements. Further, I hereby attest to the independence of the firm, if a subsidiary, in the practice of consulting engineering.
Name of the Principal/Officer	Title

The Membership committee recommends that this application be: ( ) Approved ( ) Disapproved
____________ Dated Voted	_______________________ Chairman, Membership Committee
Approved by Board of Directors:
___________ Date Voted	__________________________ President, ACEC-NH


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