Michigan State University BMES Local Student Membership Application

New Member Returning Member

Last Name First Name M.I.

Address:

City: State: Zip Code:

Phone: E-mail:

Student Membership

· Local Membership-$25.00

o Available to any student majoring in biomedical engineering or any related science. Membership entitles students to participate in events sponsored by the MSU chapter of BMES.

· Local and National Membership-$40.00

o In addition to local membership, national membership affords students special benefits such as BMES publications, awards and scholarships, career resources and internship opportunities, online resources, and the option to attend the National BMES Conference (national membership is required to attend the conference).

Dues

Annual dues (either $25 or $40) include BMES t-shirt and cover the period from September 1^st to August 31^st. Please make checks [payable to: Michigan State University Biomedical Engineering Society.

Please Complete

Department: Expected year of Graduation:

Degree which you are pursuing:

Have you previously been active in BMES at another school?

If so, where?

Are you considering going to the national conference next year?

Yes No

Signature of Applicant: Date: