Application for corporate affiliate

Application for Corporate Affiliate

Company Name*

Corporate Nominee Name (note this contact does not have membership rights)

First

Last

Phone

Postal Address*

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

FFIELD OF INTEREST (in earthquake engineering or related subjects)*

Copy of Company's logo for display on NZSEE website

Company Website

Your preferred Bulletin delivery method: *

Online Only

Hard Copy and Online

DECLARATION
I apply to become a member of the New Zealand Society for Earthquake Engineering (Inc).

If my application is accepted, I consent to becoming a member of the Society and agree to abide by the Constitution of the Society.

I understand that annual subscription is payable upon notification of acceptance for membership, and thereafter 1 October each year.

By submitting this application, I confirm that that the information provided is correct and that I agree to this declaration.

I'm not a robot

KINDRED SOCIETIES: