Associate Membership Form

ASSOCIATE MEMBER CLASS: *

E.I.T

GOVERNMENT

CONTRACT

Name

Salutation

First Name *

Last Name *

Password must be a minimum of 6 characters long and contain at least 1 uppercase letter, 1 lowercase letter and 1 number.

Password

Confirm password

Business Address

Address 1 *

Address line 2

City *

Province

Postal Code

Country *

Present Position

Title *

Municipality Government Agency

Company *

Existing Office

Create New Office

Primary Phone Number *

Fax number

E-mail *

Previous Positions

Position 1

Position 2

Position 3

Engineering Education

Undergraduate:

University

Course

Degree

Year

Post Graduate:

University

Course

Degree

Year

Other education

Registration with Professional Engineers Ontario

Year

Discipline (civil, mechanical, etc.)

PEO Reg. No *

Sponsor

Name of sponsor (a present MEA member)

Municipality of sponsoring member

Terms *

The sponsor accepts the terms and agreements of sponsorship

Engineering Experience

Municipal

Terms *

I agree with the terms of use