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This Form can be used for new applications.  Current members can  use this Application Form to forward updates to their web page to the CCN Webmaster or  e-mail updates/changes directly to Webmaster .

Active CCN Member Qualifications

CCN Members are typically individual chemists, biochemists or chemical engineers. Other chemistry-related applicants will be considered, subject to approval by the CCN Membership Committee. Although the CCN is supported by the ACS and AIChE, it is not necessary for CCN applicants to be members of either professional society.

Benefits of Membership

Members will receive meeting notifications and can benefit from attending and participating in CCN meetings and events. They receive a web page on the CCN site and will be listed on our Directory of Consultants page, so that information about their fields of expertise and the services they provide will be available to clients and to other CCN members for networking purposes. Members are encouraged to place as much information (consider including a resume/CV, for example) on their web page to fully describe the services they provide to clients. This has been shown to significantly improve the number of inquiries regarding your skills.
Active membership dues are $25/year.

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

Our CCN meetings are open to non-members as well.

To receive email notices of CCN events, please email your name, email address, telephone number, and a brief description of your consulting work to PhilaACS@aol.com (Current CCN members and new applicants who request a web page on the CCN website will automatically be added to the email distribution list.)

Annual Dues Deadlines:
The dues year runs from Jan 1 to December 31st. Members are required to pay annual dues in order to retain their web pages on the CCN 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:

Michael R. Becker, Treasurer
Chemical Consultants Network
12 Stone Bridge Court
Langhorne, PA 19047-8004

Name	Dr. Mr. Ms Mrs. Miss
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 the 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	CCN Membership with Web Page: Dues $25/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 choose from list Agricultural Analytical Attorney Biotechnology Catalysts Chemical Education Chemical Engineering Colloids Competitive Intelligence Computers and Software Cost Analysis and Economic Evaluation Divestitures and Acquisitions Electrochemistry Electrochemical Power Sources Energy Environmental & Safety Environmental Compliance Equipment Expert Witness Extraction Food Chemistry Fuel Gas Chromatography Heat Transfer High Performance Liquid Chromatography Licensing and Technology Transfer Literature and Patent Searches Manufacturing Marketing Mass Transfer Materials Mathematical Modeling Measurement and Instrumentation Medicinal Chemistry Nanotechnology Nuclear Chemistry Operations Troubleshooting Organic Chemistry Patents Petroleum Pharmaceutical Pigments and Inks Polymers Power Process Equipment Design Process Troubleshooting Product Development Project Management Pumping and Fluid Flow Quality Reaction Engineering Regulatory Affairs Research and Development Safety and Loss Prevention Security Separations and Purification Soaps and Surfactants Spectroscopy Synthesis Technical Translation Technology Transfer Validation choose from list Agricultural Analytical Attorney Biotechnology Catalysts Chemical Education Chemical Engineering Colloids Competitive Intelligence Computers and Software Cost Analysis and Economic Evaluation Divestitures and Acquisitions Electrochemistry Electrochemical Power Sources Energy Environmental & Safety Environmental Compliance Equipment Expert Witness Extraction Food Chemistry Fuel Gas Chromatography Heat Transfer High Performance Liquid Chromatography Licensing and Technology Transfer Literature and Patent Searches Manufacturing Marketing Mass Transfer Materials Mathematical Modeling Measurement and Instrumentation Medicinal Chemistry Nanotechnology Nuclear Chemistry Operations Troubleshooting Organic Chemistry Patents Petroleum Pharmaceutical Pigments and Inks Polymers Power Process Equipment Design Process Troubleshooting Product Development Project Management Pumping and Fluid Flow Quality Reaction Engineering Regulatory Affairs Research and Development Safety and Loss Prevention Security Separations and Purification Soaps and Surfactants Spectroscopy Synthesis Technical Translation Technology Transfer Validation choose from list Agricultural Analytical Attorney Biotechnology Catalysts Chemical Education Chemical Engineering Colloids Competitive Intelligence Computers and Software Cost Analysis and Economic Evaluation Divestitures and Acquisitions Electrochemistry Electrochemical Power Sources Energy Environmental & Safety Environmental Compliance Equipment Expert Witness Extraction Food Chemistry Fuel Gas Chromatography Heat Transfer High Performance Liquid Chromatography Licensing and Technology Transfer Literature and Patent Searches Manufacturing Marketing Mass Transfer Materials Mathematical Modeling Measurement and Instrumentation Medicinal Chemistry Nanotechnology Nuclear Chemistry Operations Troubleshooting Organic Chemistry Patents Petroleum Pharmaceutical Pigments and Inks Polymers Power Process Equipment Design Process Troubleshooting Product Development Project Management Pumping and Fluid Flow Quality Reaction Engineering Regulatory Affairs Research and Development Safety and Loss Prevention Security Separations and Purification Soaps and Surfactants Spectroscopy Synthesis Technical Translation Technology Transfer Validation And/Or Enter Unlisted Fields Below:
Description of Services	You may include as much text as necessary to fully describe your services.
Print the page before you press this button. Select when have the printout in hand. Note: Works best with FireFox, Internet Explorer, Netscape. Some members have indicated issues with Safari in attempting to send in the form. Select to clear all fields and start over. CCN does not send an Invoice Please send your check and printed form to: Michael R. Becker, Treasurer Chemical Consultants Network 12 Stone Bridge Court Langhorne, PA 19047-8004 Checks should be made Payable to: Chemical Consultants Network

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The ideas, advice and positions expressed by individual members of the Chemical Consultants Network are the member's own and not the responsibility of CCN or its sponsors, the American Chemical Society and the American Institute of Chemical Engineers.
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