Nomination Form for Life Membership Life Membership status can be granted to any Member who is retired and has been a Member in good standing for a minimum of 25 accumulated years. Once ASPE's Staff has verified that the nominee meets these requirements, the Society Board of Directors will ratify the results and grant the individual Life Member status. All rights and privileges of one’s membership shall also apply to this membership category, except that Life Members shall not be required to pay annual dues and shall not receive Plumbing Engineering Design Handbook materials. Nominating Chapter Name Chapter President Name ASPE Member Nominated for Life Membership First Middle Last Membership Number Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Email Describe Demonstrated Contributions (non-monetary) to the CHAPTEREXAMPLES: Service as Officer or Board of Directors; service as member/chair committees; provided leadership for technical, legislative, education, and/or membership activities and/or events; significant activity or event for community benefiting Chapter or Society; other significant contributions, assistance or endeavors on behalf or Chapter or Society.Describe Significance of ContributionDescribe Demonstrated Contributions (non-monetary) to the SOCIETYEXAMPLES: Service as Officer or Board of Directors; service as member/chair committees; provided leadership for technical, legislative, education, and/or membership activities and/or events; significant activity or event for community benefiting Chapter or Society; other significant contributions, assistance or endeavors on behalf or Chapter or Society.Describe Significance of ContributionAdditional pertinent information that should be considered.Certification by President of Chapter Nominating ASPE Member for Life MembershipThe undersigned certifies that all statements made herein are true and that the Chapter Board of Directors has approved this nomination. Signature of Chapter President Date