N-CAOMS Membership Form
Thank you for your interest in the Northern Chapter of the California Association of Orientation and Mobility Specialists (N-CAOMS). CAOMS is a non-profit statewide organization whose mission is to facilitate professional growth and to support the role of Orientation and Mobility (O&M) Specialists in the habilitation and education of individuals who have visual impairments.

Founded in 1966, CAOMS hosts an annual statewide conference. Membership consists primarily of credentialed O&M Specialists. Student and associate memberships also make up the ranks of its membership. Anyone who believes in the goals and mission of CAOMS is welcome to join. Visit the CAOMS website to at www.caoms.org to learn more.

To become a new N-CAOMS member, or renew your N-CAOMS membership, simply complete the form below and submit payment. Additional details will be included in this form. Alternately, you may complete the CAOMS Membership form available from the CAOMS website here: http://www.caoms.org/downloads/Membership_Application.pdf

Please feel free to contact the current N-CAOMS Membership Chair at ncaomsmembership@gmail.com with any feedback or questions.
Email address *
Name: *
Date of Membership Applicaiton: *
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Street Address: *
City: *
State: *
Zip: *
Preferred Phone Number: *
Job Title: *
Employer: *
Would you like to be included in the N-CAOMS member directory? *
Northern CAOMS Membership Type Information:
Regular memberships are open to all certified Orientation and Mobility Specialists.

Student memberships are for those individuals who attend an AER- approved college or university, and are currently enrolled in an Orientation and Mobility Specialist program.

Associate memberships are for all others who would like to join in support of our organization.

All memberships are valid for one calendar year beginning January 1st.

No renewals for the current year will be accepted after October 1st. Renewals received after October 1st will be applied to the following year.

In accordance with our bylaws, only regular members may vote.

All members receive the following benefits:
- Subscription to the chapter newsletter
- Free local chapter presentations
- Networking opportunities at chapter meetings and social functions
- Access to the annual CAOMS statewide conference at a reduced cost
Is this a new or renewed N-CAOMS Membership? *
Northern CAOMS Membership Type and Annual Dues: *
Required
For Regular Membership: How many years of membership would you like to pay for? *
Would you like to contribute to the Northern CAOMS Ron Turner Memorial Scholarship Fund? *
If yes, please specify amount of your contribution to the Ron Turner Memorial Scholarship Fund:
Total Payment Amount: *
Payment Methods:
Northern CAOMS Membership and Scholarship payments may be completed in the following ways:

Mail to current N CAOMS Membership Chair at:
CAOMS Membership
c/o Summer Beasley
PO Box 4082
Bremerton, WA 98312

Pay via Venmo to current N-CAOMS Treasurer to Robert.Alminana.56@gmail.com

Pay via Zelle to current N-CAOMS Treasurer to Robert.Alminana.56@gmail.com

Other: Please e-mail the current N-CAOMS Membership Chair at ncaomsmembership@gmail.com with requests to make payments in alternate methods (i.e. purchase order through employer, etc.)
How To Send and Receive Money with Venmo
How Zelle Works
What Method of Payment do you plan to use? *
Thank You!
Thank you for your new or renewed membership to Northern CAOMS - we are thrilled to have you! Once your payment has cleared and been confirmed with the N-CAOMS Treasurer, a receipt for your N-CAOMS Membership will be sent in PDF format to your listed e-mail address. Please feel free to contact the N-CAOMS Membership Chair at ncaomsmembership@gmail.com with any feedback or questions regarding your N-CAOMS Membership.
A copy of your responses will be emailed to the address you provided.
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