* 1. Please complete the Membership Application:

* 2. What topics would you like to see in workshops or seminars?

* 3. Do you have any professional concerns?

* 4. I would like to volunteer to serve with the following committee(s):

* 5. I would like to be considered for service on the Board of Directors.

* 6. I will be paying for my 2017 Membership Dues via (instructions on next page):