GEDC Membership Application

GEDC Membership Application
Name*

First NameFamily (Last) Name
Organization*
Organization URL*
Position*
E-mail*
Phone Number*

Country codePhone Number
Fax Number

Country codeFax Number
Address*

Street Address

Street Address Line 2

CityState / Province / Territory

Postal / Zip Code
Country*
Name and title of person or board you report to*
Administrative assistant name
Administrative assistant e-mail
example@example.com
Billing contact name*
Billing contact e-mail*
example@example.com
After the GEDC Secretariat receives this completed membership form, an invoice with membership dues will be sent to the billing contact designated above. Membership fees are listed below this application. If your country is not listed, or you have questions, please contact Dr. Hans Jürgen Hoyer or Jessica Londoño
Organization detail
Mission and vision of the organization you lead (or link to detail)
Principal educational and research activities of your organization
Organization logo*

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Membership detail
What conditions for membership do you meet? Check all that apply.*

A person in charge of an engineering college, school or faculty in a universityA person in charge of an educational institution of higher learning that is primarily focused on engineering education or researchA person in charge of an engineering deans organization in a respective country and/or regionOther
Please select which membership level you are applying for*

Regular Member — See membership fee for your country belowFormer Dean — Contact Dr. Hoyer for membership feeCorporate Partner — $6,000 per yearQuality Partnership — $5,000 per yearOrganization Affiliate — $2,500 per year
Personal Detail
Photo*

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Biography — You can also link to your biography or submit as an attachment on the next line*
Bio upload (if not written or linked above)

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Please verify that you are human*
Application Date:

MonthDayYear
Date
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GEDC Membership Application

Organization detail

Membership detail

Personal Detail