AES Full Membership Completion Form

ADDITIONAL INFORMATION REQUIRED FOR FULL MEMBERSHIP

Please fill out completely (in English) and press "submit" at bottom of page.
Note: you should not fill out this form until after you have received your member number.
If you don't know your member number then contact the webmaster.
A PDF version of this form is also available.

1 MEMBER INFORMATION:

*Your Name:
*AES Member Number:
*Country of Residence:
*E-mail Address:

*All "Member Information" fields are required.

2 EDUCATION

Institution:	Place:
Major or Subject:	Attended from: to:
Degree awarded:	Number of years credit if no degree:

Institution:	Place:
Major or Subject:	Attended from: to:
Degree awarded:	Number of years credit if no degree:

Other Degrees/Institutions: (Give approx. hours of study involved)

Seminars, short courses related to audio: (Give approx. hours of study involved)

3 OTHER ACCOMPLISHMENTS: (list any papers, patents, etc. with appropriate dates)

Member of other societies:

Linguistic Abilities:

4 EMPLOYMENT HISTORY:

Current Employment Start Date: End Date: Position:
Company name & location:
Duties performed:

Previous Employment Start Date: End Date: Position:
Company name & location:
Duties performed:

Previous Employment Start Date: End Date: Position:
Company name & location:
Duties performed:

Other past experience (Include dates, company, position and duties)

5 REFERENCES: (3 references, in total, required for full membership)
Your references should be individuals (they need not be AES members) who can personally attest
to your qualifications and interests and you should tell them that you are using their names.

Name: Title or Position:
Company name:
AES Member Number, or if not AES Member, then Email address or Phone number:

Name: Title or Position:
Company name:
AES Member Number, or if not AES Member, then Email address or Phone number:

Name: Title or Position:
Company name:
AES Member Number, or if not AES Member, then Email address or Phone number: