To the Georgian Association of Consulting Engineers (ACEG) (ID 405198646): I, *

First Name

Last Name

I declare that the information given below is true and the work of the applicant is connected with the consulting engineering services, either directly or indirectly and I am interested in supporting the objectives of ACEG. Therefore, I wish to apply as a (please choose one of the following considering the nature of your professional activity): *

Voting Member (who gains revenues from providing consulting engineering and/or architectural services, who adheres to the Code of Ethics and the principles of professional integrity)

Affiliated Member (who is interested in the consulting engineering activity and in supporting the objectives of ACEG)

Name of the Applicant *

For legal persons - please provide full name of your company

First Name

Last Name

Address for communication *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Does your firm or do you provide consulting engineering services? *

Yes

No

How would you define your or your company’s professional activity? *

Engineering

Architecture

Construction

Project Management

Planning

Environmental

Multi-disciplinary

Quantity Surveying

Other (please specify below)

Is your firm or are you a resident in Georgia or is your business conducted within Georgia? *

Yes

No

Date *

MM

DD

YYYY

Declaration *

By submitting this membership application, (1) you confirm that you have read and agree to abide with the membership terms of the Georgian Association of Consulting Engineers, including the Charter (and any amendments to it) and the principles of professional integrity listed in it and the Code of Ethics of ACEG; (2) you agree that the Georgian Association of Consulting Engineers may collect, use and disclose your personal data, as provided in this application for, or obtained by the ACEG as a result of your membership, for the following purposes in accordance with the Georgian legislation: (a) processing of this membership application; and (b) public administration of the membership with the ACEG.

I confirm and agree with this declaration

I do not confirm and agree with this declaration