MEMBERSHIP APPLICATION (Please print or type) NAME_______________________________________ CSR #__________ HOME ADDRESS (confidential)____________________________________________________ CITY, STATE, ZIP CODE ____________________________________________________________ HOME PHONE (confidential) (_____)________________ WORK PHONE (_____)________________ WORK ADDRESS _________________________________________ WORK COUNTY (required) _______________________________ CITY, STATE, ZIP CODE ____________________________________________________________ FAX (_____)________________ E-MAIL ADDRESS___________________________ Where would you like your mailings sent: __ Home __ Office CAT Software System:_________________________________________ __ $120 Official/Official Pro Tempore Member Any court reporter regularly employed as an Official Court Reporter or Official Court Reporter Pro Tempore in, and paid directly by, the Superior Courts of the State of California. __ $105 Pro Tempore Member Any person whose work primarily as a Court Reporter in the Superior Courts of the State of California. __ $90 Associate Member Any person who supports the profession of the Official Court Reporter. __ $60 Retired Member Retired Official/Pro Tempore. __ $35 Student Member Any person who is enrolled in the study of verbatim stenographic court reporting. Your school name and address: ______________________________________________________________ __ $0 Instructor Member Complimentary membership to instructors who are non-reporting CSRs or are not CSRs at institutions recognized/certified by the CRBC upon receipt of a completed application. Name of school: _______________________________ Show your support by becoming a COCRA Sponsor. (Please note: Sponsorship fees are in addition to dues.) You will receive special recognition in COCRA's newsletter. __Bronze Team Member $100 __Silver Team Member $250 __Gold Team Member $500 __Platinum Team Member $1000 and above Note: Dues renewable on anniversary date of membership. Dues/Sponsorship are 100% deductible. Legislative fund contributions are nondeductible __ Check Enclosed (payable to COCRA) __ MasterCard/VISA Account Number ______________________________ Exp. Date ________ Signature (required for credit card processing) ________________________________________________ Send your payment and application to: COCRA, 1215 K Street, Suite 2290, Sacramento, CA 95814 Credit card payments can be faxed to (916) 231-2141. New CSRs qualify for the $25 student rate. |