Affiliated Agency Membership Application

Institute of Transportation Engineers

 

Agency _________________________________________________________________________________________________

Membership Contact

Name: _________________________________________________________________________________________________

Title:___________________________________________________________________________________________________

Mailing Address: _________________________________________________________________________________________

City: ____________________________________ State/Province: _______________________________

Postal Code: ___________ Country:_____________________________

Telephone: ___________________________ FAX: ___________________________ e-mail:_____________________________

 

Billing Contact

Name: _________________________________________________________________________________________________

Title:___________________________________________________________________________________________________

Mailing Address: _________________________________________________________________________________________

City: _____________________________________ State/Province: _______________________________

Postal Code: ___________ Country:_____________________________

Telephone: ___________________________ FAX: ___________________________ e-mail:_____________________________

Membership Level: ________________________ and Annual Affiliated Agency Membership Dues $ ________________________

Purchase Order number or accompanying check: ________________________________________________________________

Will the P. O. be issued annually? Yes No

Please list all staff members to be included in membership. List the council in which each staff member wishes to participate and receive periodic mailings. Copy and add additional sheets as necessary. With regard to ITE International membership of staff members, provide a listing of names and FAX to ITE Headquarters and ITE staff will verify which individuals currently or have been ITE members.

# Name

Selected Council
Each member may select to join one council in each category (Employer-based and Technical) for free. Employer-based Councils: Public Agency, Transportation Consultants or Transportation Education. Technical Councils: Freight Mobility, Management & Operations/ITS, Pedestrian and Bicycle, Parking, Traffic Engineering, Transit, Transportation Expert Witness, Transportation Planning or Transportation Safety.

International Member
(Yes/No)
For non-members please attach a chronological resume and a completed first page of an ITE membership application.
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Terms: Billing is annual and the membership year runs from January 1 to December 31. Renewal billings rendered in October for the subsequent year. Renewal billings are due January 1st. New member billings are rendered upon acceptance and are due on receipt. Payment is in U.S. funds only.

Return completed form and attachments to:

Institute of Transportation Engineers
1627 I ("Eye") Street, NW, Suite 600
Washington, DC 20006 USA
Telephone: +1 202-785-0060 | Fax: +1 202-898-4131