ACEC Members | ACEC Manitoba

Title *

Manitoba Office Address *

Please indicate head office or branch office:

Head Office in Manitoba
Head Office outside Manitoba

Phone *

Fax

E-mail *

Year Established

Services Offered (Brief explanation of area of specialization): *

Form of Organization: *

Sole Proprietorship
Partnership
Private Company
Public Company

Total personnel employed on average during the preceding calendar year:

Total registered professional engineers on average during the preceding calendar year:

Officers, Directors or Partners of the Firm

	Name *	Title *	Province(s) of Registration As (Professional) Engineer *
1
1

Add Row

References. Contact information for three references who are voting representatives of the ACEC-MB member firms in good standing. *

	Name/Firm	E-mail
1
2
3
1

Conflict of Interest. In submitting this application for membership I/we confirm that there is no conflict of interest or potential conflict of interest which affects, or might affect, my/our primary business of providing consulting engineering services to the public. *

I Confirm

I agree to be bound by the Charter and Bylaws of the Association. *

I agree

Company Name and E-mail *

Membership Application