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CPRT Membership Application Form
This form is intended for individuals representing an organization interested in joining or continuing membership on the Child Protection Roundtable (CPRT). Upon completing the fields below, the information will be sent for review to the CPRT Steering Committee. The Steering Committee will make all determinations regarding Roundtable membership consistent with the Membership section of the CPRT Charter.
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Organization Name: *
City Where Primary Office is Located *
Organizational Mission and Vision: *
Organization web address:
Type of Membership
Regular Members – This category includes all members who are eligible to participate in all aspects of the Roundtable’s work, including voting on matters of policy positions.
 
Resource Members – This category includes members who are eligible to participate in all aspects of the Roundtable’s work except for voting on matters of policy positions. This category will include all representatives of the Executive, Legislative and Judicial Branches of the State of Texas and any other organizations and entities who are restricted from or otherwise choose to not vote on matters of policy positions.


Please choose one: *
Primary Point of Contact
Name *
Title at Organization
Phone: *
Email: *
Secondary Contact (if applicable)
Name
Title at Organization
Phone:
Email:
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