CALPELRA 2018-2019 Member / Friend
(Membership Year July 1, 2018 - June 30, 2019)



Thank you for your interest in becoming a 2018-2019 CALPELRA member or Friend. The 2018-2019 membership year begins on July 1, 2018, and ends on June 30, 2019.

Learn more about member and Friend definitions and benefits here.

Current members and Friends only enter user name and password to log in above; new members and Friends will be assigned a user name and password after submitting this form and completing the member/Friend application process.

Members and Friends contact each other through our password-protected Member Directory. Choose the information you would like to share with other members and Friends by checking the boxes to the right of each field below:

Prefix:*
 First or Nickname:*
 Last:*
Job Title: *
Job Responsibilities Description:
Date of Hire:
 Date began this titled role:
Agency:*
 Agency Category:
Department:
Address:*
City:*
 State:*
 Zip:*
Phone:*
      		 Cell Phone or Alt. Number:
      
Fax:
      		 Agency Web Site:
E-mail:*
 Share Confirmation E-mail with:
How did you hear about CALPELRA?

If other, please explain:
* Indicates a required field

Membership Type
Membership type I am applying for: *


Next Steps

1: Please carefully review your entries above and then click the submit button to apply for CALPELRA member or Friend status.

2: You will see payment options on the next screen.

3: Upload your photograph to the CALPELRA Member Directory on the following screen.
 
Please contact CALPELRA's Executive Office at 925-400-6320 with any questions.

* Indicates a required field.