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Student Membership Application

Print out this form & Mail or Fax it to:
National Safety Council
3241 Paysphere Circle
Chicago, IL 60674
Fax: (630) 775-2185
e-mail: customerservice@nsc.org

Student membership is offered to any full-time student enrolled in an accredited junior, undergraduate or graduate degree program with interest in areas encompassing the National Safety Council's mission and work.

Please print this form, complete all sections, and return it to NSC along with your dues, payable in U.S. funds.

Name:
University/College:
Address During Academic Year:
City:
State/Province/Country:
Postal Code:
Permanent Address:
City:
State/Province/Country:
Postal Code:
Phone Number:
E-mail Address:

Send all Membership materials to my: Address during Academic Year    Permanent Address

Please check here if you prefer not to receive:

NSC electronic communications
Non-NSC communications
Recognition in NSC membership materials


Faculty Verification of Student Status
(to be completed by university/college faculty member):

A copy of your current class schedule or other evidence of enrollment must also be submitted.

Faculty Name/Title:
Faculty Signature (to verify student status):
University/College:
Department/Program:
Street Address:
City:
State/Province/Country:
Postal Code:
Phone Number:
Fax Number:
e-mail Address:


Student Membership Benefits and Special Privileges

  • Members Only Website containing member-exclusive information and special product offerings
  • Key electronic information addressing pertinent safety and health issues:
    • Membership Advantage newsletter
    • Industry information on Members Only Website
  • Substantial member discount on programs, products and services
  • Library Services, offering technical assistance, safety literature, and timely compliance-related information requests via mail, phone, fax, e-mail and Members Only online bibliographic database
  • Volunteer and committee service opportunity within your industry
  • Member recognition at special NSC events
Industry-Specific Networking Groups

As a member of the National Safety Council, you can be a safety leader by volunteering your time and talents to industry-specific networking groups.

Networking offers members a forum to:

  • Meet and work with other members and industry leaders
  • Examine safety, health and environmental issues
  • Contribute to projects geared to resolving these issues
  • Participate in technical content preparation of products and programs
  • Review and provide training to members
  • Develop public policy statements
Volunteers plan and create programs for NSC's annual Congress & Expo, and act as a forum for continuing discussion of research findings, new concepts, trends and solutions for current challenges within each industry.

I want to learn more about networking groups.


Student Membership Dues
(Dues are stated and payable in U.S. dollars.)
Annual
 $35.00


Payment Options

Payment must accompany this application.

Bill My Credit Card:

Visa
Master Card
American Express
Discover

Card Number:
Expiration Date: (MM/YY)
Name as it appears on Card:

Signature: ________________________________

Check Enclosed (payable in U.S. funds to National Safety Council)

Questions? Contact customerservice@nsc.org with any questions on membership with the National Safety Council. Thank you.


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July 13, 2006