CBSOA Registration/Renewal and Member Contact Update
Use this form to join CBSOA, update, remove or add new contact information.

If you complete this form and are overdue for annual dues, you will receive an invoice via the email provided before your information is updated in the database.

Each member must fill this this out on their own so we have the ability to communicate with the entire membership rather than agency representatives. Registration for training events are separate from this form and can be on a per-agency basis.

Email address *
Cell phone (or other preferred contact)
Your answer
I am a... *
I will pay my annual dues along with this form (if agency is paying, or you paid at training, note in "Other" below) *
First Name *
Your answer
Last Name *
Your answer
Mailing Address (The Beacon magazine, Member ID card, etc) *
Your answer
Mailing City *
Your answer
Mailing State *
Your answer
Mailing Zip *
Your answer
Contact info to be removed (if applicable)
Your answer
My Agency *
Your answer
Agency Address
Your answer
Agency City
Your answer
Agency State
Your answer
Agency Zip
Your answer
I have been a member of CBSOA since... (year)
Your answer
I am in the _____________ region of California. *
Boss's title *
Your answer
Boss's first name *
Your answer
Boss's last name *
Your answer
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