Information about http://www.sbe.org/pdf/Senior%20Upgrade%20App.pdf
APPLICATION FOR UPGRADE TO SENIOR MEMBERSHIP …
Tags: address business, broadcast engineers, business phone, business place, city state zip, date of birth, dd, e mail address, fax number, home business, indianapolis, job title, mailing address, membership card, membership society, north meridian street, place of employment, state zip code, yy,Pages: 1
Language: english
Created: Thu May 22 10:34:39 2003
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APPLICATION FOR UPGRADE TO SENIOR MEMBERSHIP
SOCIETY OF BROADCAST ENGINEERS
9247 North Meridian Street, Suite 305
Indianapolis, IN 46260
Phone: (317) 846-9000 Fax: (317) 846-9120 (Please type or print)
Applicant must be a current SBE member who has SBE Member #____________________
at least five (5) years of consecutive membership
with the Society at the time of application. Member Since (found on your membership card) ____________________
______________________________________________________________ _(________)________________
Last Name First MI Home Phone
______________________________________________________________ _(________)________________
Mailing Address Business Phone
______________________________________________________________ _(________)________________
City State Zip Code Fax Number
Is the above mailing address (circle one): Home Business
___________________________________________________________________ _____________________________
Place of Employment Date Employed Date of Birth (MM/DD/YY) optional
_______________________________ ________________________________ _____________________________
Current Job Title Type of Facility E-mail Address
_____________________________________________________________________________________________________
Description of Duties
Applicant must have at least 15 years active participation in broadcast engineering or its allied fields.
Total years of responsible Engineering experience: _________ Radio TV Other (check all that apply)
Applicant must have demonstrated professional responsibility in one or more of the following areas:
supervision, equipment design, physical plant design, marketing and/or equipment-systems integration.
Give a description of your experience in any of these areas. You may also attach a current resume.
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
____________________________ _________________________________________________________________
Date Signature
MEMBERSHIP COMMITTEE ACTION
Approve Disapprove Grade:_____________________
Comment: ____________________________________________ Records: ___________________
Signature: _____________________________________________ Appl Notified: ______________