DIRECTED ENERGY PROFESSIONAL SOCIETY


 Membership Application for Sponsor Employees

DEPS Sponsors receive an allocation of free DEPS memberships to provide to their employees. This allocation is based on the level of sponsorship, however educational institutions receive an unlimited allocation.

Please use this form to submit the necessary membership information to DEPS. Asterisks note the fields required by DEPS to process your membership.

Full Name: *
Title:
Organization: *
 
Mailing Address: *
City: *
State: *
Zip code: *
 
Phone: *
Fax:
E-mail: *
 
Membership category: Annual Dues
      Sponsor employee Free within sponsor's allocation or if sponsor is educational institution
 
Are you renewing your membership? *    Yes    No
If yes, what is your member number? *   
 
 
Optional personal information (used for Society satistical records only):
Highest degree      Institution:
Degree discipline:      Year:
Birth Year:      Interest area:
Referred by:    
       
Information in this form will be used for Society membership records and statistics. We may at times publish membership information. If you do not want your name or address released, please check here:
       
Do not release my e-mail or mailing address Do not release my name and organization
 
 

Once you have completed the information on this form, press the Submit button to send this information to DEPS. The Reset button will clear the entire form.

     

 
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Last updated: 16 January 2003