First Name
Last Name
Home Address / City / State/Province
Zip/Postal
Country
Education
College or University Attended and Degrees Earned:
Major Program of Study:
Cumulative Grade Point Average:
Year of Graduation:
A complete application will require the following:
1. Provide your ASHRAE membership number in the following space:
2. Describe your professional goals in the space below (Answer 100 to 200 words). What is your interest in the field covered by ASHRAE? Do you have a special interest in HVAC&R equipment or systems (i.e., commissioning, installing, designing, testing, troubleshooting, teaching)?
3. Discuss your previous HVAC&R involvement in the space below (Answer 100 words or less). To what extent have youparticipated in HVAC&R activities to advance your above stated “goals”?
4. Provide a list of activities you have participated in ASHRAE demonstrating leadership ability, character, and work ethic(Answer 500 words or less).
5. Supply a brief resume of your work experience in chronological order, starting with the most recent, in the space below.
6. List your membership in professional or honorary societies/organizations, including office(s) held (if applicable), in the spacebelow.
Evaluation Form
7. Have your local ASHRAE chapter complete the Evaluation Form (can be found at the top of this page). This award, upon acceptance, is for reimbursement of the application fee after successful completion of the exam.