b'AUSTRALIAN SOCIETY OF EXPLORATION GEOPHYSICISTS A.B.N. 71 000 876 040 PO BOX 576, CROWS NEST NSW 1585 AUSTRALIA Phone: +61 2 9431 8691Fax: +61 2 9431 8677 Email: secretary@aseg.org.auWebsite: www.aseg.org.au Application for Active & Associate Membership 2024 INSTRUCTIONS FOR APPLICANTS 1. Determine the membership level you wish to apply for, according to the 3. Submit the two pages of your application to the Secretariat at theeligibility criteria outlined in Section 2. address shown on the top of this page, retaining a copy for your2. Fill out the application form. Note that applicants for Active Membership own records. The Secretariat will generate an invoice for payment must nominate a proposer and a seconder who are Active Members of that includes payment instructions.ASEG. Under exceptional circumstances the Federal Executive The invoice will be sent electronically so please check your emailCommittee may waive these requirements. inbox and spam folders.Section 1.Personal Identification SurnameDate of Birth Given NamesTitle Address CountryStatePost Code Organisation E-mailE-mail (alternate)MobilePhone (W)Phone (H) Section 2.Choice of Membership Grade (Active or Associate) q Active Please complete all sections q Associate Please complete all sections apart from Section 4 (Nominators) q GraduatePlease complete Active or Associate application and also check this box Student Please complete the separate Student Membership Application Form Activean applicant must be actively engaged in practising or teaching geophysics ora related scientific field. Conditions for ActiveMembership include a relevant academic qualification. Any person who does not have such qualifications, but who has been actively engaged in the relevant fields of interest of the Society for at least five years, shall also be eligible for Active Membership upon the discretion of the Federal Executive Committee. Associatean applicant must be actively interested in the objectives of the Society. Associate Members are automatically eligible for election to Active Membership after five years as an Associate Member. GraduateActive or Associate membership is subsidized by 50% for no more than two years after completion of studies. Members accepting the graduate grant are expected to contribute to society activities and publications with the goals of raising their profile in the society and showing ASEGs support of young professionals. Studentan applicant must be a full-time graduate or undergraduate student in good standing, registered at a recognised university or institute and working towards a degree in geophysics or a related field. Eligibility for Student Membership shall terminate at the close of the calendar year in which the Student Member ceases their graduate or undergraduate studies. The duration of a Student Membership is limited to five years. Section 3.Academic and Professional Qualifications Month/Year (FromTo)Organisation/InstitutionPosition/Degree (incl. Major)Professional Record Only: Years of Independent Work Online profile (eg LinkedIn, Google Scholar)University/ Professional webpage Section 4.Nominators of Active Membership applicants must be ACTIVE Members of ASEG NominatorNamePostal or e-mail addressPhone/Fax Proposer Seconder 60 PREVIEWAPRIL 2024'