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New England Chapter Society of Explosives Engineers
P. O. Box 596
Hudson, MA 01749
Tel. 978-562-6211 Fax. 978-562-2662 nesee@nesee.org

APPLICATION FOR MEMBERSHIP
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Company Name:__________________________________________
Company Address:________________________________________
Home Phone:____________________________________________
Company Phone:_________________________________________
Email Address:___________________________________________
Fax Number:_____________________________________________
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Dues:
$ 40.00 – New England Chapter Member [ ]

Please print this page and attach with check and mail to: (do not combine invoices, one check per person)
NESEE, P. O. Box 596, Hudson MA 01749