SBE Member Application

Required fields are marked with ^*

Membership

Please select the appropriate membership category.

Category ^*	Dues
Regular Member	$85 USD
Regular Member with MemberPlus Option	$175 USD
Associate Member	$85 USD
Student Member	$25 USD
Student Member with MemberPlus Option	$90 USD
Reinstatement	$85 USD
Change in grade to Member For student/youth members only	$85 USD

If reinstating, Former Member Number:

Promo Code:

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 Line 1:^*

Address Line 2:

City:^*

State/Province: Required for US and Canada members

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 format

Employment

Place of Employment:^*

Date Employed:^* MM/YYYY format

Current Job Title:^*

Type of Facility:^*

Description of Duties:^*

Experience

Total years of responsible Engineering experience:^*

Type of experience:
Check all that apply

Radio

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:^* MM/YYYY format

To:^* MM/YYYY format

Company Name and Location:^*

Position or Title:^*

Type of Facility:^*

From: MM/YYYY format

To: MM/YYYY format

Company Name and Location:

Position or Title:

Type of Facility:

From: MM/YYYY format

To: MM/YYYY format

Company Name and Location:

Position or Title:

Type of Facility:

From: MM/YYYY format

To: MM/YYYY format

Company Name and Location:

Position or Title:

Type of Facility:

References

List two references who are familiar with your work. Both references are required.

Name:

Company Name and Location:

Position or Title:

Phone:

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

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 your name constitutes signature

SBE Member Application

Membership

Contact Information

Employment

Experience

Experience Record

Education

References

Other Professional Licenses or Certificates

Special Achievements