NEIA - Student Application

Student Membership Application

Application
Renewal (please update each field, or enter N/C for no change)

Student Member Annual Fees Including HST: $20.00

Name:

Permanent Address:

City:

Province:

Postal Code:

Tel:

E-mail:

Personal Web site:

Program Type:

Name of Institution:

Course of Study:

Graduation Date:

Please briefly describe your career plans and interest in the environmental industry. Also inform us when you are available for work terms, graduation dates, etc. (apr. 150 words or less):

I hereby agree to join / renew as a member of NEIA. I acknowledge that this information I provided is accurate to the best of my knowledge, and I agree to the standards of NEIA and its Code of Ethics.

I will forward payment to NEIA within 30 days.

Make cheque / money order payable to: NEIA, and send to:

NEIA
90 O'Leary Avenue
St. John's, NL A1B 2C7