NCAC-USAEE Student Membership Application

Student Membership Application Form

Annual Student Membership Dues are $10.00

To become a Student Member please fill out the form below and bring it to the next NCAC event, along with your Student Identification Card.

Alternatively, you may mail the form, copy of your Student Identification Card, and your check to:

NCAC-USAEE Treasurer, Mark Lively

Utility Economic Engineers

19012 High Point Drive

Gaithersburg, MD 20879

Phone: (301) 428-3618

NCAC-USAEE Student Membership registration/renewal is expected by the end of the preceding calendar year.
Annual Student Membership Dues are $10.00.
Please make checks payable to NCAC/USAEE.

2009 NCAC-USAEE Membership and Renewal Form
		I am applying for New Student Membership.
		I am a Renewing Student Member.
Name:
Address:
State and Zip:
Telephone:
FAX:
**Email:
		Provide the best e-mail address** to receive the newsletter.
University or College:
Area of Concentration:

Yes No		I am interested in becoming more involved in NCAC-USAEE by serving on the Council.

Please list topics or speakers which most interest you: