Missouri Society of Professional Engineers Sustaining Organization Application
PLEASE INDICATE NAME OF SUSTAINING ORGANIZATION AS IT SHOULD APPEAR IN ALL MSPE LISTINGS:

NAME____________________________________________________________

ADDRESS_________________________________________________________

__________________________________________________________________

PHONE___________________________________________________________

PLEASE LIST PERSON(S) REPRESENTING SUSTAINING ORGANIZATION: You may list two (2) representatives for the first $250 donated and one (1) additional representative for each $200 thereafter. NOTE: Sustaining Organization donation cannot be credited toward individual membership.

Name and Title (Key Contact)_______________________________________
Name and Title___________________________________________________
Name and Title___________________________________________________

*Payments may be deductible under the Internal Revenue Code, but are not deductible as charitable contributions.

-Attached is a three-quarter (3/4) page typewritten double spaced narrative profiling our organization for publication in The Missouri Engineer. We understand that upon enrollment an eighth (1/8) page in the newspaper will be used to feature our enrollment and profile at no charge. Normal display rate for this space would be $205.

___ Attached is check for $___________

___ Bill us for $____________

See Donation Schedule.

(Applications are subject to review and approval by MSPE's Executive Committee.)

Return to:
Missouri Society of Professional Engineers
200 E. McCarty, Suite 200
Jefferson City, Missouri 65101-3113
Phone (573) 636-4861 Fax (573) 636-5475