Southern Ontario Chapter

2011/2012 Season: Application for Southern Ontario Chapter

This is a:  Renewal,  Revisions,  New Application
For revisions, indicate only the changed information. Please print:
Name
Present Occupation/Title	Telephones
Employer	Business
Business Address	Fax
Home Address	Home
Mailing Address:  Business,  Home	Other
E-mail

Please indicate area of the fire protection industry in which you are employed:
Consulting/Contractor	Standards / Testing
Government	Student
Insurance	Retired
Manufacturing/Equipment Sales	Other

	Please include payment for Annual Dues as indicated below (fees are for September 1, 2011 to August 31, 2012)
	$30.00, if you are currently a member of SFPE International and are paying SFPE International annual dues. Your designation will be Chapter Member.
	$30.00, if you have not paid SFPE International annual dues. Your designation will be Chapter Colleague.
	$10.00 for retirees.
	$5.00 for student members.

Date: __________ Signature of Applicant:___________________________

To apply in person please bring completed form and cash or cheque payment to a scheduled SFPE SOC luncheon presentation.

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Advancing the Science and Practice of Fire Protection Engineering Internationally 

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