RESC Membership Application

Name FIRST

Name LAST

Address 1

Address 2

City

State

Zip

E-Mail, "Required for Confirmation"

Phone

Area CodePhone Number

Are you a PE

PE State

PE Name

PE Number

Former or Present Employer

Employment Location

Retirement Date

Employment Field or Activity

Technical / Professional Society Membership

Hobbles, Sports, Clubs, etc.

Volunteer Activities

RESC member name (if introduced or invited by a member)

Select One of 3 Payment Options (Make Check Payable to RESC)

1. Land Mail Personal Check to:

RESC.

6092 Eddington Street

Liberty Township, OH 45044

2. My Bank is Sending a Check via "Bill Pay"

3. Bringing Personal Check to Meeting NO CASH

Annual Membership Dues $18.00-Payable in October. {$9.00 after January, New Members Only}

Information Call 513-392-1093

How are you paying ?

Comments and other information:

0/200

You should receive a confirmation email from RESC. If you do not receive a confirmation please email the webmaster

Photo/Video/Audio Policy: RESC recording staff as designated by the presiding officer may take photos/video/audio recordings at our activities. Selected recorded material may be used in our newsletter, and/or web site, and/or may be made available to the public as promotional issuance. Attendance constitutes acceptance of this policy. Members are encouraged to advise their guests of this policy prior to the activity. Requests to be excluded from recording must be communicated personally at the event to RESC recording staff.