1. MEMBERSHIP APPLICATION
CONTACT INFORMATION
ANNUAL DUES
Please print:
o Mr. o Mrs.
If You are joining sme only
o One-Year Membership
o Two-Year Membership
o Three-Year Membership
o Ms.
o Dr.
o PE
Name_______________________________________________________________________________
First
Middle Initial
Last
Job Title_____________________________________________________________________________
Number of years employed in manufacturing___________ Date of Birth___________________________
Business Email_______________________________________________________________________
Home Email__________________________________________________________________________
o Please check here if you wish to have your name withheld from organizations other than SME.
NOTE: Many member benefits and announcements are distributed electronically. Please include your
email and keep it updated at sme.org/update.
Check a Preferred Address for Receiving Information from SME o Work o Home
WORK ADDRESS
HOME ADDRESS
Company/Organization Name:
Street_________________________________________
_____________________________________________
City__________________________________________
Division/Dept___________________________________
State/Province__________________________________
Street_________________________________________
Country_______________________________________
City__________________________________________
Phone ________________________________________
State/Province__________________________________
Cell Phone_____________________________________
SME EDUCATION FOUNDATION DONATION
(optional—tax deductible)
o $25
o $50
o $100
o Other_________________
RECIPROCAL MEMBERSHIP (Optional)
SME has partnered with AME to offer a dues discount when you
join both. Simply check the appropriate box below and enjoy the
benefits of both!
SME and AME (Association for Manufacturing Excellence)
$259.00 (for both)
$472.00 (for both)
$665.00 (for both)
o One-Year Membership
o Two-Year Membership
o Three-Year Membership
TOTAL AMOUNT ENCLOSED (U.S.D.) $_________________
SPONSOR INFORMATION
Did a colleague encourage you to join?
Zip+4/Postal Code_______________________________
Mail Stop/Building_______________________________
$138.00
$248.50
$352.00
Zip+4/Postal Code_______________________________
Country_______________________________________
Business Phone ________________________________
Cell Phone_____________________________________
Fax___________________________________________
Staff size of your company
Check one box only
o (1) Less than 20
o (5) 250-499
o (3) 50-99
o (7) 1000-2499
o (2) 20-49
o (4) 100-249
o (6) 500-999
o (8) Over 2500
Job Function (check one box only)
o 2) wner/Company Management/Corporate Executive
O
o 3A) Manufacturing Production Management
o 3B) anufacturing Production Department
M
(non-management)
o 4A) Manufacturing Engineering Management
o 4B) anufacturing EngineeringDepartment
M
(non-management)
o 5) Quality Assurance Control
o 6) Product Design RD
o 7) Control Engineering/Automation
o 9D) Educator/Instructor
o 10) Other
Your Company’s Primary End Product Manufactured or
Service Performed ________________________________
______________________________________________
Education: Highest Degree Achieved (check one)
o Highschool o Technician
o Associate
o Bachelor o Master
o Doctorate
INDICATE the SME Technical
CommunitY THAT alignS with
your EXPERTISE.
no extra charge!
(See reverse side for descriptions.)
o Automated Manufacturing Assembly
o Forming Fabricating
o Industrial Laser
o Machining Material Removal
o Manufacturing Education Research
o Plastics, Composites Coatings
o Product Process Design and Management
Dave Davidson, C248
Sponsoring Member’s Name____________________________
000011808944-0
Sponsoring Member’s Number__________________________
PAYMENT OPTIONS
Method of Payment: o Check/Money Order
Credit Card:
o MC
o VISA
o DISCOVER
o AMEX
Card Number_________________________________________
Expiration Date__________________CC #________________
Signature_____________________________________________
o
up for auto renewal. At renewal time your credit card
Sign
will be charged the current membership rate. Please call SME
Customer Care to modify or opt out of this program.
Convenient Ways to Join:
1. ONLINE: sme.org/join (credit card only)
2. CALL:
(Credit Card only) 800.733.4763 (U.S.) or
313.425.3000, Ext. 4500 (Outside U.S.)
3. Fax:
313.425.3401 (Credit Card only)
4. Mail: SME
Attn: Customer Care
One SME Drive – P.O. Box 930
Dearborn, MI 48121- 0930 USA
o Rapid Technologies Additive Manufacturing
Yes
Indicate the technical specialties most related to
your interests. Write up to four category codes here:
(See reverse side for list)
No
Yes
AREAS OF INTEREST
No
(1)__________________ (3)________________
(2)__________________ (4)________________
Local chapter Affiliation
Membership in your local SME chapter is a free benefit.
We will place you in the chapter nearest your preferred
address or you can write in a specific chapter below.
This form valid through 12/31/13
headquarters use only
CODE
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