*copy and paste into word, then mail to the secretary treasurer, see 'contact us' link*

APPLICATION FOR MEMBERSHIP IN THE NEW MEXICO ASSOCIATION OF

PROFESSIONAL SOIL SCIENTISTS

NAME: _________________________________________________________________

ADDRESS:_______________________________________________________________                    _______________________________________________________________

PHONE NUMBER: _______________________E-MAIL __________________________

I hereby request membership into the New Mexico Association of Professional Soil Scientists. 

My qualifications are as follows:

EDUCATION

HIGH SCHOOL: __________________________GRADUATION DATE: _____________

                                   _________________________________________________________          

COLLEGE: ____________________________GRADUATION DATE: _____________

(undergrad) ____________________________MAJOR: _________________________

(post-undergrad)_________________________GRADUATION DATE: _____________

                       ____________________________MAJOR: _________________________

NUMBER OF HOURS IN - BIOLOGICAL SCIENCES:  ____________________                                                                                              

                                                PHYSICAL SCIENCES:        ____________________

                                                EARTH SCIENCES:              ____________________

NUMBER OF HOURS IN SOILS: ________________________________________

PROFESSIONAL EXPERIENCE

1.     EMPLOYER: ______________________ JOB TITLE: _________________________

ADDRESS:___________________________________________________________

EMPLOYMENT DATES: from _______ to_______ JOB DESCRIPTION: ___________

____________________________________________________________________

2.     EMPLOYER: ______________________ JOB TITLE: _________________________

ADDRESS:____________________________________________________________

EMPLOYMENT DATES: from _______ to ______ JOB DESCRIPTION: ___________

____________________________________________________________________

3.     EMPLOYER: _______________________ JOB TITLE: ________________________

ADDRESS:____________________________________________________________

EMPLOYMENT DATES: from_______ to_______ JOB DESCRIPTION: ___________

____________________________________________________________________

I hereby verify that the above information is true. ___________________________________

Signature                       Date