Environmental Professionals of Arizona

2007-2008 Membership Application Form

Please complete our Online Application Form and use the submit button to send by e-mail. At this time, we do not have a secure server to process your dues online. Please mail your payment to P.O. Box 60663, Phoenix, AZ 85082. Thank you.

First Name:
Last Name:
Job Title:
Environmental Focus:
Business/Industry Type:
Company:
Street Address:

Suite/Mail Stop:
City, State Zip:
Phone:	include area code (no spaces)
Email:
Fax:	include area code (no spaces)
Membership Type:

Corporate Members to include:
Corp Member #2	e-mail #2
Corp Member #3	e-mail #3
Corp Member #4	e-mail #4
Corp Member #5	e-mail #5

Please provide a brief description of your business activity:
I am interested in one or more of the following Committee Opportunities (please select any of interest): Membership: Recruits and maintains members and encourages participation from a range of business enterprises, government and educational groups. Rules, Regulations & Certification: Maintains by-laws and coordinates elections; gathers and provides information and support in obtaining professional credentials and registrations within the environmental community. Maintains knowledge of upcoming regulation changes and new regulations that will affect the environmental industry and the members of EPAZ. Advises program committee of specific regulatory topics. Products & Technology: Gathers and highlights new and innovative approaches to manage, replace or reduce hazardous materials or prevent pollutions. Programs: Participates in the coordination of the annual conference. Web Site: Gathers news and information to be posted to the website, updates of membership and encourages banner advertising. Programs: Plans outreach events with trade associations, educational institutions and various government agencies to fund-raise for EPAZ scholarships.

Membership Dues
Professionals	$60 / year
Corporate (includes up to 5 employees)	$225 / year
Student (include copy of Student ID)	$15 / year

Please make checks payable to the
Environmental Professionals of Arizona (EPAZ)
Membership dues for the 2007-2008 year must have been received by November 1st. Benefits of membership include: Monthly e-mail meeting reminders. Monthly luncheon meetings with guest speakers (held on the second Thursday of the month). Monthly networking mixer (held on the last Wednesday of the month). Annual Gatekeeper Regulatory Roundup two-day conference. Web site promoting networking opportunities. To verify your membership expiration date, please see your member listing on this site. Click here. You can send this form via email by clicking the submit button. Please followup with a check sent to: P.O. Box 60663 Phoenix, AZ 85082

Membership Dues