Indiana Structural Engineers Association

Member Application

* First

* Last

Title

* Company

* Business Address

* City

* State

* Zip

* Phone

* Email

* Are you a licensed P.E. in Indiana

Yes
No

If applicable, please input your Indiana P.E. registration number

Are you a licensed S.E.

Yes
No

If applicable, please input the State and S.E. registration number

If not a P.E. or S.E., do you currently hold E.I.T. status

Yes
No

In which state do you hold E.I.T status?

* Are you currently a student enrolled in an ABET accredited engineering or technical program?

Yes
No

School Name

Type of program

2 year
4 year
Gradute

* Category of Membership

Member
Associate Member
Student Member
Affiliate Member

Your participation and contribution to various ISEA Committees would be greatly appreciated. Please indicate if you would like to be involved in any of the following:

Membership Committee
Scholarship Committee
Spring Conference Committee
Website/Communications Committee