Member Application – Safety Executives of New York, Inc

Eligibility Requirements for SENY Membership

Must work in the NY/Metro Area.
Must work in the EH&S Field.
Must be highest ranking EH&S officer of the company for the Metro Area.
One member per Parent Corporation. If there is a safety director of a subsidiary corporation who has independent direction of a subsidiary program, such person may become a member, in addition to the safety director, of the parent.

All fields are required.

General Information

First Name Last Name Phone Number (555-555-5555) Email Address SENY Member Sponsor

step 1 of 4

Employment Information

Employer Business Address Business City Business State Business Zip

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Current Position

Title Length of time in current position Length of time in the EH&S profession Title of person to whom you report Define your management scope and responsibilities (250 characters max) Additional Professional Experience (safety related affiliations, organizations, committees)

step 3 of 4

Resume Upload (should reflect at least last 5 years of work experience)

PDF or MS Word formats (DOC, DOCX)

Application Completed On:

step 4 of 4