Technical
Exploration
Center

Membership Form

Directions: After filling in the required information, click on the "Print Form" button below to print out this form. Mail this printed form, along with your check (payable to Husson College) to: Technical Exploration Center,30-34 Summer St, Bangor, ME 04401

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City/Town
State/Province
Zip/Postal Code
County
Work Phone
Home Phone
FAX
E-mail

Choose one of the following Membership Levels:

$50 Individual Membership
$125 Professional Membership
$350 School/Business Membership

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