Membership Registration
Please fill in each blank and hit the submit button to complete the registration process. Name Email Address Title/Position Are you the Chief Engineer? Yes No Hospital/Company Bed Size Street Suite/Unit City State Zip AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY Phone Fax How long have you been in the field of hospital facilities, clinical, radiological, telecommunications, or safety engineering? 0-6 months 6 months-1 year 1-5 years 5-10 years 10-15 years 15-20 years 20+ years Please list the major responsibilities in your position Type of membership you are applying for? 1 Year Member ($40) 1 Year Associate ($40)
