Membership Application 

 Date of Application                                     

 Name:                                                                                                                                                         

Company Name:                                                                                    e-mail:                                          

Mailing Address:                                                                                                                                        

Town or City:                                                       County:                            State:         Zip:                   

 Telephone Home:                                              Business:                                        Fax:                            

 Private Practice: yes                 no                      License #                                      L.S.           P.E.           

List of membership in other organizations:                                                                                                                                                                                                                                                                                                            

Students list school attending:                                                                                                               

Endorsement: I hereby recommend the above named individual for membership in CALS:

 Name:                                                                                         Title:                                                             

 I wish to serve on the following committees.  Anyone may serve on a committee.  Everyone should serve on at least one committee.

 Annual Meeting   Annual Reference Book   Attorney/Surveyor Liaison   Awards   Budget & Finance   County Director

General Membership Meetings   GIS    Historical   Internet   Legislation   Map Design Competition   Membership

Professional Development   Public Relations   Publications   Scholarship Program   Update Business Practices     Other:              

Membership Fee  $