FY15 Associate Membership Application
Please complete entire form and forward a copy to SWE Headquarters, Attn: Jennifer Scott, 203 North La Salle
Street, Suite 1675, Chicago, IL 60601 or fax to 312-596-5252 or email jennifer.scott@swe.org. If you have any
questions contact SWE at 312-596-5223.
 New Associate Membership
 Renewing Associate Membership
Company and Contact Information
Name of Company
Address
City
State
Zip
URL for SWE website listing
Type of business/industry
Primary Contact
Contact Title
Phone
Fax:
Email Address
Payment
 Check enclosed (made payable in US dollars to: SWE).
 American Express
Credit Card Number
Cardholder Name
Authorized Signature
 Visa
 Discover
 Please invoice me.
 MasterCard
Exp Date
Associate Membership Application
Employee Identification for Membership
Employee #1
Name
Title
Company:
Address
City
State
Phone
Fax:
Zip
Email Address:
SWE ID (if a renewing member):
Employee #2
Name
Title
Company:
Address
City
State
Phone
Fax:
Zip
Email Address:
SWE ID (if a renewing member):
Employee #3
Name
Title
Company:
Address
City
State
Phone
Fax:
Email Address:
SWE ID (if a renewing member):
Zip