MEMBERSHIP APPLICATION - INDIVIDUAL

You may join SEAoT online using the form below. Or you may download and mail in your application.

To download an application in a pdf format, click here. For word format, click here.

THIS IS THE INDIVIDUAL MEMBER APPLICATION - For Corporate Membership, click here

CONTACT INFORMATION
 Title First Name I Last Name Suffix
Nickname:
EMPLOYMENT
Company
Address
Address continued
City State Zip:
Work Phone
Fax
Primary Email
Alternate Email
HOME ADDRESS
Home Address
City: State Zip:
How did you hear about SEAoT?
If Other Source, please specify
SEAOT MEMBERSHIP
Membership Select your membership category
Chapter Select the chapter you wish to join
New members selecting the join the Fort Worth Chapter will be intially assigned to the North Central
Texas Chapter until the Fort Worth Chapter is fully functional.
Please set up your log in access. This will allow you to view and update your contact information online.
Log in (primary email address) Please use your primary email address.
Password  
EDUCATION
College/University
College Location  
Highest Degree Date
PROFESSIONAL ENGINEER REGISTRATION
State #
State #
PROFESSIONAL EXAMS PASSED
Exam
Location Date
Exam
Location Date
REFERENCES (Licensed Professional Engineering Practicing Structural Engineering in Texas
Reference 1
Tel
Email
 Is person a SEAoT Member
Reference 2
Tel
Email
 Is person a SEAoT Member
PROFESSIONAL EXPERIENCE
Position 1
Company 1 Date
Position 2
Company 2 Date
Position 3
Company 3 Date
SUPPLEMENTARY EXPERIENCE (Not required for Affiliate Membership Category)
Briefly describe your current positon and responsibilities as they relate to structural engineering
Briefly describe three projects you have worked on within the last three years. Include design,
dates of completion, description of project and description of your responsibilities.