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ARIZONA COUNCIL OF ENGINEERING AND SCIENTIFIC ASSOCIATIONS
2009 FISCAL YEAR
If you are interested in becoming a member or are renewing your membership to ACESA, please fill out the following form.
Individuals may join with no dues required, however, they must be approved by the board of directors and there are certain participation requirements to maintain membership.
SOCIETY DUES INVOICE AND ROSTER UPDATE
Organization Name ______________________________________________
Representative #1
Name ____________________________________________________
Title______________________________________________________
Address __________________________________________________
__________________________________________________
Phone (Business) __________________ (Home) _________________
FAX ____________________ email ____________________________
Representative #2
Name ____________________________________________________
Title______________________________________________________
Address __________________________________________________
__________________________________________________
Phone (Business) __________________ (Home) _________________
FAX ____________________ email ____________________________
Dues Statement
Fiscal Year 2009
Societies ....................
$25.00
_________________________________________________________
Dues amount remitted
. $____________
Please make checks payable to Arizona Council of Engineering and Scientific Associations
Bring to ACESA meeting or mail to:
ACESA
c/o Ray Quackenbush
270 E. Chelsea Ln.
Gilbert, AZ 85295-5986
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