MEMBERSHIP/DUES FORM 2017 - 2018
Membership will be effective on your anniversary date emitted by ASHRAE society

Chapter Year: $60.00    Students: $10.00     Life Members: N.C.


- ROSTER INFORMATION -
Name:
Spouse:
Firm:
Business Address:
City:
State:
Zip:
Phone:
Fax:
E-mail:
Society Membership Number:

Society Grade:

Presidential
Life
Fellow
Member
Associate
Affliliate
Student

Indicate First, Second and Third Choice for Committee Assignment:
First Choice:
Second Choice:
Third Choice:
If 'Other' Please specify:

MAILING INFORMATION:

Please Fill out completely
Name:
Firm:
Street Address:
City:
State:
Zip:

Total Enclosed $:

Make checks payable to: Southern California Chapter, ASHRAE
P.O.Box 80133
San Marino, CA 91118