BETEC MEMBERSHIP APPLICATION FORM

To become a member of the Building Enclosure Technology and Environment Council,
please print, complete and return the following application form:

Name________________________________________________________________

Title__________________________________________________________________

Company______________________________________________________________

Address_______________________________________________________________

City/State/ZIP Code_____________________________________________________

Telephone (_____)____________________ Fax (_____)________________________

E-Mail Address:________________________________________________________

MEMBERSHIP CATEGORY:

___ Individual Member - $100

___ Corporate Member - $250 (optional alternate member)

GROUP CLASSIFICATION:

[  ] Consumer/Public Interest Group [  ] Trade Association [  ] Labor Organization
[  ] Code & Standards Organization [  ] Academic Institution [  ] Product Manufacturer
[  ] Builders/Building Contractors [  ] Professional Society [  ] Material Supplier
[  ] Federal, State, Local Government [  ] Other (describe)_______________________

RESEARCH COORDINATING COMMITTEES:

I will participate on the following Research Coordinating Committees (RCC's):

[  ] Heat Air and Moisture  [  ] Fenestration  [  ] Membranes  [  ] Materials and Resources 
[  ] Existing Building Enclosures [  ] Education [  ] Window Security Rating and Certification System

OPERATIONAL COMMITTEES:

I will participate on the following Operational Committees (OC's):

[  ] Technology Transfer   [  ] National Program Plan   [  ] Network for the Advancement of Building Science

ALTERNATE MEMBER INFORMATION (corporate members only):

Alternate Name:_____________________________________________________

Alternate Title:______________________________________________________

Alternate's RCC's and OC's____________________________________________

DUES PAYMENT:

____ Check or Money Order enclosed payable to BETEC

____ Please bill my Credit Card: ___AMEX ___MC ___VISA

Account No. _______________________________________________________

Exp. Date_____________ Cardholder's Name______________________________

Credit Card Billing Address: (if different from above)__________________________

__________________________________________________________________

____ Please bill me.

Send information to:

Building Enclosure Technology and Environment Council
1090 Vermont Avenue, NW, Suite 700
Washington, DC 20005-4905
Phone: (202) 289-7800
Fax: (202) 289-1092
Email: nibs@nibs.org