Last Name:

Approved Please Do NOT Type in This Space

FOR OFFICE USE ONLY
Student Dues - $32 per year
Contact Information:
Prefix: Mr. Mrs. Ms. Dr. Male Female

Name: Last: Zuiga Guia First: Gabriel Arnaldo MI:

School Name: Universidad Nacional de San Agustn Major: Ingeniera de Minas
Email Address: Arnaldo1248@gmail.com Birth Date: 12/10/1992
School Mailing Address
Street or PO Box: Esq. Av. Independencia/ Paucarpata s/n - Cercado
City: Arequipa State: Arequipa Zip/PC 5154 Country Per
Phone: 244498 Fax: 244498
Home Mailing Address:

Street or PO Box: Avenida Espinar 117- Miraflores

City: Arequipa State: Arequipa Zip/PC 5154 Country Per
Phone: 958658662 Fax:
Preferred Mailing Address: Home School

Student Member Qualifications

A person eligible for election into the class of Student Member must be a full-time college undergraduate or graduate student in
good standing. A professional Member who subsequently returns to school for an additional degree cannot become a Student
Member. All Student Members must be nominated by an existing Member.
Signature
If elected, I agree to abide by the bylaws and rules of the Society for Mining, Metallurgy, and Exploration, Inc. as the same are now in effect and as
they may hereafter be modified while I am a member. I understand that under certain laws and regulations, SME must have my permission in order
to communicate with me via fax or email. I hereby give SME Foundation, SME Local Sections and SME business associates permission to send me
information and advertisements. If SME does NOT have your permission to communicate with you via fax or email, you many not have access to
some of your electronic member benefits.

Signature: (type or sign your name) GabrielZG Date:

Endorsement
Student Member application must be endorsed by an SME Professional or Registered Member.

Name: Gustavo Adolfo Garca Avils Member #: 4194043

If you currently do not have an endorser, check this box and we will assign one for you.

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SME Membership was recommended to me by: Eng. Jorge Luis Parisuaa Ccapa
Continued on next page
Society for Mining, Metallurgy, and Exploration, Inc. 12999 E. Adam Aircraft Circle Englewood, CO 80112
Phone: (303) 948-4204 Fax: (303) 948-4265 e-mail: emas@smenet.org

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Education
Please list school, degree, major, and the date of graduation. Student Members must be full-time students at a school approved by SME
Name of School: Universidad Nacional De San Agustn
Expected Degree: Ingeniera Major: Ingeniera de Minas
Expected Date of Graduation: Diciembre del 2016

Divisional/Technical Interest
Please indicate, in order of preference (1, 2, 3), a minimum of one and no more than three, technical interest categories.
Divisions: Coal & Energy (F) Technical Bulk Material Handling (M)
Environmental (E) Interest Education (J)
Industrial Minerals (H) Committees:
3 International Marine Minerals (I)
1 Mining & Exploration (Metallics) (A)
Mineral & Metallurgical Processing (B)
2 Underground Construction Association (U)

Industry Sector
Coal Mining (1B) Geology/Exploration (8) Metallurgy (9)
Coal Processing (6) Government (2) Metals Mining (1A)
Economics (4) Industrial Minerals Mining (1C) Metals Processing (10)
Education (3) Industrial Minerals Processing (1D) Underground Construction/Tunneling (11)
Environmental (7) Manufacturing (5)

Payment
DUES ARE PAYABLE ON A CALENDAR YEAR BASIS. PAYMENT MUST ACCOMPANY APPLICATION.
Credit Card Check Cash Wire Transfer (contact SME at emas@smenet.org for instructions)

Credit Card Info: Visa MasterCard American Express Discover

Card Number: Expiry: Sec. Code
Signature (type or sign your name):

Dues: $ 32
Total $ 32 Please calculate your total here (US Dollars)

UPON COMPLETION OF APPLICATION SEND TO:

Email: emas@smenet.org or
Fax: (303) 948-4265 or
Mail: Society for Mining, Metallurgy, & Exploration
12999 E. Adam Aircraft Circle
Englewood, CO 80112
Questions? Please contact Billie Emas at (303) 948-4204 or toll free (800) 763-3132 or
emas@smenet.org

THANK YOU!