Proposal for Membership (432196e7-2099-4abe-b2fd-961d2fea42fb)

Mr. Address Member is hereby proposed by the undersigned, as a Associate Junior Member of the American Institute of Mining Engineers. Signature of three Members. or Associates (not Junior Members). Place of birth Year of birth . Education, when, where and how acquired, with degrees, if any. A technical education is not requisite for membership. Dates Please give record of experience on following page with dates; for example, in the form used by ?Who's Who In America" and similar publications.