Cumberland Chapter of URISA Membership Form
Fill out the information below to submit your membership application to the Cumberland Chapter of URISA. You do not need to reside or work in Kentucky/Tennessee to be a member. For membership questions, please contact info@cumberlandurisa.org.

First Name *
Your answer
Last Name *
Your answer
Job Title *
Your answer
Organization/School *
Your answer
Preferred Address *
Your answer
City *
Your answer
State *
Zip *
Your answer
E-mail Address *
Your answer
Phone Number
Your answer
Are you a URISA International Member? *
Are you a Certified GISP? *
Membership Type *
Membership dues are paid by calendar year.
Payment Options *
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