SEA Wisconsin - Member Application Form

* First Name

* Last Name

* Email Address

Phone Number

Mailing Address

Mailing Address (Line 2)

City

State

Zip Code

Company Name

* Region

Northeast
Northwest
Southeast
Southwest

Committee Interest Are you interested in participating in any of the following committees? Committee participation is voluntary. We are merely looking for your interest areas.

Awards Committee
Communications Committee
Continuing Education and Programming Committee
Legislative Committee
Membership Committee
Structural Engineering Emergency Response (SEER) Committee
Young Member Committee

* Member Category Professional Membership: $85, Student (Unemployed) Membership: $30

Professional Member
Student Member

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