ACEC/CO - Membership Info - Membership Application

Membership Info - Membership Application

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AMERICAN COUNCIL OF ENGINEERING COMPANIES of Colorado
800 Grant Street, Suite 100, Denver, CO 80203
Phone 303 832-2200, Fax 303 832-0400
E-Mail acec@acec-co.org
Web www.acec-co.org

BEFORE SELECTING MEMBERSHIP CATEGORY, PLEASE REVIEW THE MEMBERSHIP BYLAWS.
ACEC/CO does not condition membership on any health status-related factor relating to an individual (including an employee of any employer or a dependent of an employee.

Please fill out application and send $100 fee, the application will not be acted upon until payment is received

APPLICATION

Membership Type :

First Name

Middle Name

(Last Name)

Spouse Name:

Firm Name:

(Total # of Employees at this office)

Position at Firm:

FIELD(S) OF QUALIFIED PRACTICE (FOR ENGINEERING PRINCIPALS ONLY)
(State Fields of Practice that you are qualified in, not those of your firm)

Business Address:

Street Address

City

State

Zip Code

Phone

Fax

Email

Website

Home Address:

Street Address

City

State

Zip Code

Phone

IN WHICH STATES OR POSSESSIONS ARE YOU LICENSED (REGISTERED) TO PRACTICE ENGINEERING?

Colorado Registration Date:

Colorado Registration NO.:

List at least three members of the American Council of Engineering Companies of Colorado or derivative members of the American Council of Engineering Companies whom you believe would be willing to supply information about you. Listing these members implies your permission for a contact to be made with them to secure information about you.

1. Name

Firm

Street Address

City

State

Zip

2. Name

Firm

Street Address

City

State

Zip

3. Name

Firm

Street Address

City

State

Zip

4. Name

Firm

Street Address

City

State

Zip

5. Name

Firm

Street Address

City

State

Zip

EDUCATION:
List in chronological order the name and location of each college, university or technical school from where you have received credit:

Name:

Location:

From
To:
Date Graduated

Course Major

Degree Received

Name:

Location:

From
To:
Date Graduated

Course Major

Degree Received

Name:

Location:

From
To:
Date Graduated

Course Major

Degree Received

Name:

Location:

From
To:
Date Graduated

Course Major

Degree Received

List the Professional and Technical Organizations in which you hold membership. (Indicate offices held)

Organization Offices held

I understand the qualifications set forth in Article VI of the American Council of Engineering Companies of Colorado By-Laws and am eligible for membership.

Do you spend at least 85% of your time in the business of private practice of Consulting Engineering offering services to more than one client, with an office in the State of Colorado?
Yes
No

If your firm is a subsidiary, branch or part of a conglomerate organization, please explain.

If you are engaged in other than Consulting Engineering, such as construction or commercial sales, explain.

If you are engaged in professional services of a scientific and technical nature that are complementary to services provided by member firms, explain.

I hereby make application for membership in the American Council of Engineering Companies of Colorado, and if elected to membership I will comply with its Constitution and By-Laws and adhere to its Code of Ethics. I further certify all statements on this form have been truthfully answered.

For statistical purposes, please indicate which of the following services your firm provides. Include only in-house capability by virtue of experience and having a principal registered in the specific field. :

To make multiple selections hold down the

Ctrl key and click with the mouse (IBM)

Command key and click with the mouse (MAC)
Other please specify:

Principals:

Key Principal:

Other Principals:

Firm Activities (50 words or less)

Ownership:

Subsidiary or Branch Office of (Firm, City, State) NOTICE TO APPLICANT

Annual dues will be charged to your firm or company in accordance with the By-Laws. Dues are billed quarterly, and payable on receipt of statement. Annual dues are based on a member-firm basis and are determined from a formula relating to number of principals and personnel in each firm and to the total of ACEC Colorado budget approved for the ensuing year.

Members accepted during July, August and September shall pay dues for the entire year; members accepted during October, November and December shall pay dues for three-fourths of the year; members accepted during January, February and March shall pay dues for one-half of the year; and members accepted during April, May and June shall pay dues for one-fourth of the year.
ACEC/CO does not condition membership on any health status-related factor relating to an individual (including an employee of any employer or a dependent of an employee).

American Council of Engineering Companies of Colorado, "ACEC/CO"
The Voice of Colorado's Engineering Industry.