Individual Membership

Title Mr. Mrs. Ms. Dr. Prof. Other.
Business Title

Last Name
First Name
Middle Name
Suffix
YES! I would like to join the Environmental & Water Resources Institute.
I am currently a member of ASCE and wish to select EWRI as my primary Institute at no additional cost.
*ASCE Member ID *Must provide if currently an ASCE member
I am currently a member of ASCE and SEI/G-I/AEI and wish to join EWRI as an additional Institute.
I would like to join EWRI only.
I would like to join EWRI as a student.

Personal Information (Complete this section if you are not already an ASCE member or if you want to correct ASCE Membership data)

Residence

Address
City State Zip
Country
Phone #

Business

Name of Employer
Address
City State Zip
Country
Phone #
Fax #
E-mail

Please Click Below Your Preferred Mailing Address:

Residence
Business

Date of Birth Social Security #

Business/Position Category

Type of Business

Consulting   Consulting Engineering Firm, Engineer in Private Practice
 
Contractor   Contractor
 
Government   Federal
  Regional Authority
  State
  Municipal, County, Township & District
  Foreign
 
Industry/Utility   Commercial and/or Industrial Organizations (including transportation and privately owned utility companies)
  Producer of Construction Materials
  Manufacturer of Equipment and Supplies
 
Education   Student
  Educator, Professor, Instructor
  Special Interest Organization, Association
  Other

Educational Information

Please use appropriate abbreviations when possible. Please list all degrees received or being pursued, using appropriate abbreviations (i.e., BSCE, MSCE, Ph.D., MBA, MSEM)

College/
University		 Dates Attended/
Attending		 Degree/
Major		 Graduation
Date

Professinal/Work Experience

You may paste a recent resume in lieu of completing this section.


Name of Employer
& Name, Title
of Supervisor
Length of
Employment
Position Description/
Assignment
Years Months
Years Months
Years Months

How many years have you participated in the environmental and water resources industry?

Please provide a brief statement describing your participation in the environmental and water resources industry.

Professional Licenses and Associations

Please list professional licenses and professional association affiliations:

Payment Information and Signature

Membership
Category
Qualifications
Total Due
ASCE and EWRI Joint Membership ($200) Membership materials for ASCE will be forwarded to you. $
EWRI Membership as an Additional Institute ($20) For current members of ASCE and SEI, G-I, or ARI - Institutes of ASCE. $
EWRI-Only Membership ($85) For individuals engaged in the development of policies and programs related to water resources and the environment including the planning, design, construction, operation, management, and regulation of associated engineered works $
Student ($0) For full-time students interested in the environmental or water resources field of practice $

*Annual dues do not need to be included with your application. You will be invoiced for dues once your application has been processed. FAx your completed application to 703-295-6333 or mail to ASCE-EWRI MEMBERSHIP, 1801 Alexander Bell Drive, Reston, VA 20191-4400 USA



I authorize the Institute to verify the information contained in this application and, to that end, to contact any educational institution, professional society, publisher, employer, or other entity 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 the Environmental and Water Resources Institute 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.


Date: