CEG/CSEG Certification Student Form - The Association of Technology, Management, and Applied Engineering

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CEG/CSEG Certification Student Form

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If you are already an ATMAE member, please sign in first to receive the member rate.

Fees:
Current ATMAE Student Member: $25
New ATMAE Student Member: $50 (this includes 1 year of ATMAE Membership and certification fees)

If you have any questions, please contact info@ATMAE.org

Applicant Information

Title
First Name *
Last Name *
Professional Title
Company/Department
Address Line 1 *
Address Line 2
City *		State *
Zip/Postal Code *		Country
Email Address *
Phone Area Code *		Phone *
Education Eligibility
My last academic year before receiving my degree. *Anticipated graduation date required if you have not graduated yet.
Academic Advisor Name *
Advisor Phone *
Advisor Email *
Graduation Date *
Certification Exam Information
(Information about passing the ATMAE CEG/CSEG Certification Exam)
School *
Date *
Individual Exam Session Date *
Select Certification Level *
*(For CSEG, please upload your independent documentation of professional development activities)
Divisions: Please select the division(s) you would like to be a part of	CCTI Construction EECT Graphics Management Manufacturing Safety Student University Women in Technology Distance Learning Focus Group Micro/Nanotechnology Focus Group
Verification/Authorization
I hereby attest that all information is correct. I hereby authorize ATMAE staff to make any inquiries necessary to verify the information submitted.
Signature (type full name) *
Today's Date *

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