CCN Application Form

This form can be used for new applications. Current members can also use this form to update their web pages and/or contact information.

Please note that the Chemical Consultants Network has membership requirements and two classes of membership:

Class A - Membership With Web Page
Class A members are entitled to a web page on the CCN site describing their fields of expertise and services provided. They are typically members of the American Chemical Society or the American Institute of Chemical Engineers. (By approval of the CCN membership committee, other chemical industry related applicants will be considered for Class A membership).

Dues: Member of ACS or AIChE: $25/year
Non-member of ACS or AIChE: $35/year

Class B - Membership Without Web Page
Class B members are entitled to the same benefits as Class A members, but will not receive a web page on the CCN web site. They typically have an interest or involvement with the chemical and allied sciences and industries.

Dues:
Member of ACS or AIChE: No annual fee
Non-member of ACS or AIChE: $10/year

Benefits of Membership
All members will receive notification of events and can benefit from attending and participating in CCN meetings and events. Names of Class A and Class B members will be maintained in a data base that will be provided to the general membership for networking purposes.

CCN is based in the Philadelphia, PA (USA) area, where our meetings and seminars are held. To gain full benefit from your membership you are encouraged to participate in our meetings in order to develop your networking and consulting skills.

Annual Dues Deadlines:
The dues year runs from Jan 1 to December 31st. Current members are required to pay dues for the new year by the 1st of March of that year or will be considered as non-active and will be removed from the mailing list and web site. New members' dues paid during the year up and to November 1st of that year will be current for that year. New member dues paid after November 1st will also cover the entire following year.

When you complete this form you should print it and attach it to your check. The electronic copy you send will be used to create your web page. The printed copy will confirm your membership contact information for the Treasurer and remind you that without data, your site will be useless. Checks without an attached printed copy of your application form below will not be accepted.


Checks should be made Payable to Chemical Consultants Network.
Checks and forms should be sent to:

Dr. Ron Bihovsky, Treasurer
Chemical Consultants Network
804 Primrose Lane
Wynnewood, PA 19096-1664

Name
Company
Address

City State ZIP
Country
Email
Web Site http://
Telephone Day Evening Fax
Qualifications I am a member of the American Chemical Society
My membership number is in the box below:
I am a member of the American Institute of Chemical Engineers
My membership number is in the box below:
I would like membership board of the CCN to evaluate my skills.
I can leave the box below blank,
Web Page on CCN I want a Web Page on the CCN Website.
I am submitting a New Member application.
This is an Update to my Current Web Page
I am a current member of Chemical Consultants Network
Dues Web page and Member of ACS or AIChE: Dues $25/year
Web page and Non-Member of ACS or AIChE: Dues $35/year
NO Web page and Member of ACS or AIChE: Dues $0/year
NO Web page and Member of ACS or AIChE: Dues $10/year
How Did You
Find Out About CCN?
C&E News Ad
ACS Section Publication
Web search, i.e., Google, Yahoo, etc.
Referred by friend, peer
Other Organization
Other
Fields of Expertise Select up to Three Fields of Expertise from List




And/Or Enter Unlisted Fields Below:
Description of Services


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CCN does not send an Invoice

Please send your check and printed form to:

Dr. Ron Bihovsky, Treasurer
Chemical Consultants Network
804 Primrose Lane
Wynnewood, PA 19096-1664
Checks should be made Payable to:
Chemical Consultants Network