SBE Membership Application

SBE Membership Application

Fields in red are required.

MEMBERSHIP

Please select the appropriate membership category.

 
Category
Dues
Regular Member
$82 USD
Associate Member
$82 USD
Student Member
$25 USD
Reinstatement
Former Member Number:
$82 USD
Change in grade to Member
(for student/youth members only)
$82 USD

Please indicate which chapter you would like to join if your membership application is accepted. (Find a chapter)

If accepted, please enroll me in Local Chapter #
Location
SBE Certification # (if applicable)
Sponsor’s Name/Who introduced you to SBE?

E-voting opt-out

The SBE conducts its annual election of the national board of directors online. To opt out of e-voting and vote by mail instead, check this box.

CONTACT INFORMATION

First Name
Middle Initial
Last Name

Mailing Address

Address
Address - cont
City
State/Province
(Required of US and
Canada members)
Zip Code/Postal Code
Country
The above address is:
Business
Home
Primary Phone
(used for printed and
online directories;
available only to
other SBE members)
Secondary Phone
Fax
Email
Date of Birth
(MM/DD/YY)

EMPLOYMENT

Place of Employment
Date Employed
(MM/YY)
Current Job Title
Type of Facility
Description of Duties

EXPERIENCE

Total years of responsible Engineering experience:

Type of experience - check all that apply:

Radio
TV
Other

Experience Record

List in chronological order, beginning with the most recent, all formal experience in Broadcast Engineering or related employment. Indicate field(s) of specialization under “Position.” You must list at least one experience. If a field does not apply, enter "n/a."

From
(Mo/Yr)
To
(Mo/Yr)
Company Name and Location
Position or Title
Type of Facility

EDUCATION

List in chronological order, beginning with the most recent.

From
(Mo/Yr)
To
(Mo/Yr)
College, University, Technical Institute or High School
Credits or Yrs Completed
Course or Major
Degree
Credits
Years
Credits
Years
Credits
Years
Credits
Years

* If applying for student member status, you must complete the following:

Program/major currently enrolled in:
You are a (check one):
Full-time Student
Part-time Student

Please input the contact information for one of the following: faculty advisor, dean, department chair, registrar, etc. SBE may contact to verify your student status:

Name
Title
Email
Phone

REFERENCES

List two references who are familiar with your work.

Name
Company Name and Location
Position or Title
Phone

OTHER PROFESSIONAL LICENSES OR CERTIFICATES

SPECIAL ACHIEVEMENTS

List awards, patents, books, articles, short courses, seminars related to broadcast-communications technology, etc.

Have you ever been convicted of a felony?

Yes
No

If yes, describe in full.

 

If approved, I agree to abide by the Society of Broadcast Engineers By-Laws and Canons of Ethics.

Signature
(typing name constitutes signature)

BILLING INFORMATION

Billing Address (must be the address associated with the credit card account you are using)
Same as Above Address
OR
Address:
Address - cont:
City:
State/Province:
(Required of US and
Canada members)
Zip Code/Postal Code:
Country:

Credit Card Information
Credit Card Type
Credit Card Number
Expiration Date (MM/YY)
First Name on Credit Card
Last Name on Credit Card
Verification Code*
Visa/Mastercard - The Verification Code is a three-digit number on the back of your credit card. The full credit card number is reprinted in the signature box and at the end of the number is the Verification Code.
American Express - The Verification Code is a four-digit number on the front of the card above the credit card number on either the right or the left side of your American Express credit card.

 

SBE dues are not deductible as a charitable contribution for federal income tax purposes, but may be deductible as a business expense. SBE estimates that 2% of your dues are not deductible because of SBE’s lobbying activities on behalf of its members.