FAEP Membership Application

Florida Association of Environmental Professionals
An Affiliate of the National Association of Environmental Professionals

P.O. Box 1598 * Winter Park, Florida 32790 * 1-866-767-8073 * email

New Member? Renewal? Date

Mr.

Mrs.

Ms.

Dr.

First Name:

Last Name:

M.I.

Title/Position:
Affiliation:
Address:
City:	County:	State:
ZIP+4	Phone (work):
E-Mail:	FAX:

Date of NAEP Membership:
NAEP Number:

CEP ?

Yes

Employment:

Academic

Government

Private

Type of Work:	1 Environmental Management	2 Environmental Planning
3 Environmental Compliance	4 Biology-Botany, Ecology, Wildlife Management
5 Engineering	6 Law
7 Environmental Consulting	8 Other

Area of Expertise:
10 Impact Assessment	20 Design
30 Permitting	40 Monitoring/Analysis
50 Teaching	60 Research
110 Waste Management	120 Other

Degree(s)/Year:

University:

Membership Catagories

NAEP Membership: NAEP renewals or new members must use the NAEP web site at www.naep.org to renew your NAEP membership or become a new member.

FAEP Membership:
$30 General	$30 Associate	$15 Student

GENERAL MEMBERSHIP ASSOCIATION - FAEP General Membership shall be open to all persons with three (3) years professional experience in an environmental discipline (e.g. project or task manager, etc., who exercises independent judgment in an interdisciplinary environmental field). All General Members of the FAEP shall also be General members in good standing of the NAEP. A General Member shall be considered a voting member of the Association, eligible to hold office or to be elected to the BOARD.

ASSOCIATE MEMBERSHIP - FAEP Associate Membership is open to those who do not meet the General membership requirements and to other individuals who are interested in environmental issues, ideas or technology. A Florida Associate shall be considered a voting member of the FAEP, not eligible to hold an office, but eligible to be elected to the BOARD. This category is especially applicable to recently graduated students. Those that do not have the requisite education background can remain an Associate member. Upon completion of the required professional experience, an Associate member will be granted General member status.

Local Chapter Membership: (State membership is mandatory. You may join more than one chapter):

	Central Chapter	$20
	Northeast Chapter	$20
	Northwest Chapter	$10
	Southwest Chapter	$15
	South Chapter	$25
	Space Coast Chapter	INACTIVE
	Tampa Bay Chapter	$15
	Tallahassee Chapter	$10
	Treasure Coast Chapter	$15
Total Dues:

AFFIRMATION: I hereby affirm and agree that I will abide by the Code of Ethics of the Association. I further understand that falsification of the contents of this application will be grounds for rejection and/or termination of my Association membership and revocation of all benefits resulting there from.

Signature______________________________________________________ Date:____________________________

FAEP is a not-for-profit Florida corporation, exempt from Federal income tax under section 501(a) of the Internal Revenue Code as an organization described in section 501 (c) (3). As such, a portion of your membership dues may be deductible under section 170 of the Code. Please consult your accountant or a tax professional for confirmation. FAEP is in no way affiliated with or connected to the group known as "Environmental Professionals of Florida". FEIN: 59-2966679

Please print this form and return it along with your check to:
SWFAEP

P.O. Box 1302

Fort Myers, FL 33902

If you have any questions, please email the Membership Director Alicia Kruse at: AliciaK@passarella.net

Thanks for your support!