Please accept this application along with my annual dues as my request for membership in the CSCA.
Type of Membership you are applying for: (Check one)
|Principal ($300)||Active($40)||Associate ($40)|
|Type of Vendor (if applicable):|
|Applicant’s Signature: ____________________________________________|
(Required ONLY if applying for Active Membership)
As the Coroner or Medical Examiner of County in the State of California, I hereby certify the above applicant meets the requirements for Active Membership in the California State Coroners’ Association.
Fill out form (don’t forget to sign it), then PRINT THIS FORM and mail with check payable to CSCA to: