Membership

CALIFORNIA COURT INTERPRETERS ASSOCIATION
Annual Membership Renewal Notice & Application for New Members

Personal Information

Name (last, first, middle initial):
Business Name(Institutional and Corporate Members only):
Address:
City:
State:
Zip:
Country of Residence:
Chapter Affiliation:
Home Phone:
Business Phone:
Pager:
Fax:
E-mail:
Languages:
Registered:
Non-Designated:

Certification Type and Number

CA Court:
Federal Court:
Administrative:
Medical:
Judicial Council Reg.#:
New Member:
Renewing Member:
Type of Membership
Active $95.00:
Associate 95.00:
Student (w/proof of enrollment) $45:
Institutional/Corporate $150:
Worksheet
Annual Membership(Jan1 - Dec 31):
Contribution to Ely Weinstein Scholarship Fund:
Total Amount Enclosed:

You may pay by credit card by clicking on the "PayPal" link below

Or you can pay by check, payable to CCIA, and mail it to:

1005 State Street
El Centro, CA 92243

Email: CCIA5@sbcglobal.net

This information will be included in CCIA's home page directory except for court certification or other registered numbers. If you do not wish to be listed or want any of the above information deleted from your listing, please notify CCIA.