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Please print out and fax to Nic Guindon at (780) 426-1877.

Membership #

Application for Registration University Student Membership

There are no fees to apply or to retain membership. ASAP is free for undergraduate 2nd, 3rd, or 4th year engineering or geoscience students registered at Alberta universities. Students are responsible for notifying APEGGA of any changes in personal information.

NOTE: Please ensure that you provide APEGGA with any changes in your personal information.

Name and Contact Information

Courtesy: Mr. Mrs. Ms.

Surname:
Given Name in Full:
Common Name and/or Initials:
Mailing Address:
 
City:
Province:
Postal Code:
Telephone:
Fax:
E-mail:
University Student ID #
Date of Birth:


Academic Information:

I am currently enrolled at the University of Alberta Calgary


Engineering

Chemical Geomatics Mining
Civil Manufacturing Oil & Gas
Computer Materials Petroleum
Electrical Mechanical Software
Engineering Physics    

Geology

Geophysics

Date:

Signature:_________________________________________


Head Office
1500 Scotia One
10060 Jasper Avenue NW
Edmonton AB T5J 4A2
Calgary Office
2200, Scotia Centre
700 2nd Street SW
Calgary, AB T2P 2W1
403.262.7714
Fax: 403.269.2787
   
GST Registration #R106728603