Individual Membership

LACCEI Individual Membership Application

Last Name:

First and Middle Names:

Full Name as it should appear on certificate (with title: Ing., Dr., Prof, ....):

Position:

Email:

Engineering Field(s) of Interest for Birds of a Feather Discussion Sessions (Choose One):

Will your institution be a member of LACCEI in 2003:
Yes (Your individual membership is free)

No (Individual membership = $20)

Engineering Institution:

Country:

Telephone(s)

include Country code:

Fax:

Web Page URL:

If your institution is not a LACCEI member, you will receive an email with instructions of where to mail the US$20 individual membership fees. If your institution is a LACCEI member, individual membership is free for all its faculty and administration.

Questions?/¿Preguntas?: mailto:info@laccei.org?Subject=LACCEI Individual Membership
Dr. Gustavo Roig, Florida International University, roigg@fiu.edu, 305 348-3700, FAX: 305 348-6188
Dr. Maria M. Larrondo Petrie, Florida Atlantic University petrie@fau.edu, 561 297-3899, FAX: 561 297-2659

Last Name:
First and Middle Names:
Full Name as it should appear on certificate (with title: Ing., Dr., Prof, ....):
Position:
Email:
Engineering Field(s) of Interest for Birds of a Feather Discussion Sessions (Choose One):
Will your institution be a member of LACCEI in 2003:	Yes (Your individual membership is free) No (Individual membership = $20)
Engineering Institution:
Country:
Telephone(s) include Country code:
Fax:
Web Page URL:
If your institution is not a LACCEI member, you will receive an email with instructions of where to mail the US$20 individual membership fees. If your institution is a LACCEI member, individual membership is free for all its faculty and administration.