MEMBERSHIP APPLICATION

Mr. Arlo Gambell 
NCIM Chair of Admissions
WSI Corporation 
400 Minuteman Road 
Andover, MA 01810-1093 
Ph: (978) 983-6624 
Fax: (978) 983-6408 
e-mail: agambell@wsi.com 



Applicant:

______________________________________

(Full name)

______________________________________

(address)

______________________________________

(address)

______________________________________

(city) (state) (zip)

______________________________________

(Phone)

_______________________________________

(Email address)

Membership Category:

    * Consultant Membership ($200/year)
    * Associate Membership ($75/year)
    
Please DO NOT submit an annual membership dues payment at this time. Only after your membership application has been accepted by the NCIM Board of Directors will you be contacted regarding payment.

Membership Requirements:

Consultant Membership

    * Certification as a Consulting Meteorologist (CCM) by the American Meteorological Society, AND
    * Full or part time employment in the private sector in the practice of meteorological consulting and/or meteorology related activities.

Associate Membership

    * Full or part-time employment in the private sector in meteorology or in a field where meteorology plays a significant role.
    * AND
    * Active pursuit of certification by the American Meteorological Society as a CCM, with the intent of completing certification requirements within five years of initial application.

 

CCM Number and year of award:

Please describe your experience and education.

Technical Experience

 

 
 

Academic Record

 

 

 
Professional Affiliations/Distinctions

 

 


References

(3 required, at least 2 of which must have indicated their willingness to address professional as well as personal qualifications).

1)

2)

3)

I understand that the Chairman of the Committee on Admissions may contact the above listed references for a statement concerning my qualifications.

I understand that the granting of membership in the National Council of Industrial Meteorologists is made solely at the discretion of the Board of Directors under procedures prescribed in the Articles of Incorporation and By-Laws. It is also my understanding that my membership, if granted, may be revoked at the discretion of the Board of Directors for reasons specified in the Articles of Incorporation and By-Laws. I agree to abide by the decisions of the Board of Directors in all matters pertaining to the processing of my application, granting denial or membership, or revocation of membership, if the board so decides such action is advisable. I hereby waive any right I may have by existing or future law, federal or state, to file suit against, recover damages from, or recover court costs from the National Council of Industrial Meteorologists, the Committee on Admissions or the Board of Directors in connection with my application for membership or revocation of membership.


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(Signature)

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(Date)