Safety in Chemical Engineering Education (Sache)

Safety in Chemical Engineering Education (SAChE)

Membership Enrollment Form

The applying organization is a (check one): University Corporation Other

Name of organization:

Street Address:

City: State: Postal code:

Country:

SAChE modules are sold as a whole.

See www.sache.org for summary of SACHE modules available. Access to the complete Process Safety Beacon is included with the purchase of SAChE modules.

Type of organization: / Price
·  University / Complimentary
·  Company: CCPS Member / $600 US
·  Company: CCPS Non-member / $800 US
·  Government / $600 US
Purchase Price
(see table):

SAChE Contact Name: E-mail: Phone:

Credit Card: __ AMEX __ VISA __ MasterCard Card number

Expiration

Name of Cardholder Signature

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Send application to:

Scan and email:

Mail to: AIChE, SAChE, 120 Wall Street, 23rd Floor, New York, NY 10005 USA