Membership Application Form

1. Identification

Name of Firm

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax Number

Email Address

Web Page Address

Firm's APEGA 'Permit to Practice' Number

Subsidiaries/Permanent Affiliates

Name of Firm

Street Address

Address Line 2

City

Postal Code

Phone

Fax Number

2. CEA Membership

In 1978, the Consulting Engineers of Alberta was registered as an industry association, making CEA the official voice for the consulting engineering industry in Alberta. In June 1992, the Consulting Engineers of Alberta Act was passed in the Alberta Legislature. This act confers the right to use the title "Member of Consulting Engineers of Alberta" (MCEA) exclusively to the members of CEA.

3. Membership Criteria

Each applicant for membership in CEA must satisfy the criteria stipulated in the Consulting Engineers of Alberta Act and Regulations and CEA Bylaws.

i) A partnership or other association of persons or a corporation that holds a Permit to Practice from the Association of Professional Engineers, Geologists and Geophysists of Alberta.
ii) Operate a business offering one or more of the services listed in Schedule 'A' .
iii) Maintain permanent facilities and have employees in Alberta, managed by one or more professional engineers.

Table A

Category	# of personnel
# of Engineers
# of Technicians
# of Support/Admin
# of Other Employees
Total

Table B
Total Personnel	# of Voting Reps
4 or less	1
5 - 20	2
21 - 50	3
51 - 100	4
101 - 200	5
201 - 300	6
301 - 400	7
over 400	8

4. Voting Representation

In accordance with the number allotted in Table "B" (above), please identify your Voting Representative(s) and indicate their location and email address.

Voting Representative 1

Name

Position

Location (City)

Email Address

Voting Representative 2

Name

Position

Location (City)

Email Address

Voting Representative 3

Name

Position

Location (City)

Email Address

Voting Representative 4

Name

Position

Location (City)

Email Address

Voting Representative 5

Name

Position

Location (City)

Email Address

Voting Representative 6

Name

Position

Location (City)

Email Address

Voting Representative 7

Name

Position

Location (City)

Email Address

Voting Representative 8

Name

Position

Location (City)

Email Address

5. Business Volume

To intensify CEA's lobbying and marketing power, it is important to identify the total volume of business generated by our industry. This information is confidential and will be used for the sole purpose of determining total industry billings.

Your company's gross billings during the most recent fiscal year were:

Alberta Projects

Other Canadian Projects

Foreign Billings

Gross Billings

6. Firm Profile

Please provide description about your firm.

Firm Profile

7. Schedule A

Please check the services offered by your firm.

8. Office(s) In Alberta

Our firm maintains the following permanent office(s) in Alberta

Office #1

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax

Office #2

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax

Office #3

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax

Office #4

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax

Office #5

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax

Office #6

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax

Office #7

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax

Office #8

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax

Office #9

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax

Office #10

Street Address

Address Line 2

City

Postal Code

Phone Number

Fax

9. Experience

Company's years of experience in consulting engineering

Years Experience

10. Professional Engineers Employed

Name(s) of Professional Engineer(s) employed by the firm in Alberta who has (have), after registration, more than five years experience in consulting engineering.

First Name

Last Name

Email Address

Title

APEGA Registration #

Office

First Name

Last Name

Email Address

Title

APEGA Registration #

Office

First Name

Last Name

Email Address

Title

APEGA Registration #

Office

First Name

Last Name

Email Address

Title

APEGA Registration #

Office

First Name

Last Name

Email Address

Title

APEGA Registration #

Office

11. Code of ethics.*

The firm will abide by the Code of Consulting Engineering Ethics. Click Here to view our Code of Consulting Engineering Ethics.

Yes

12. Declaration

The undersigned, as the Responsible Engineer for, certifies the information contained in this Membership Application is correct, and that the firm is in compliance with the Membership Accreditation Criteria and the CEA Code of Consulting Engineering Ethics.

Name of Responsible Engineer

Date