Application for SELC Membership - Fiscal Year 2017-18
**SELC is the newly merged organization of the Colorado Fiscal Managers Association (CFMA) and the Colorado State Managers Association (CSMA)**.
Member Information
I hereby submit my application for membership with State Employees Leading Colorado:
First Name
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Last Name
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Title
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Select Department, Higher Education, or Retired
Primary Professional Group
Required
CORE Department Code
Please enter your 4-character CORE department code (e.g. ACAA, BAAA, CAAA) or "None" if you are not a current state employee.
Your answer
Work Address
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City
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Zip Code
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Phone
Needed in case we have questions on your registration, but will not be published on the member directory.
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Email Address
Needed to receive SELC newsletters, updates, and event invitations. Please verify that the email address is correct before submitting this form.
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Payment Information
Select your annual dues:
Required
Tim Smith Memorial Scholarship Contribution Amount (optional)
Visit the educational assistance portion of the SELC website for information on the Tim Smith Memorial Scholarship.
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Method of Payment
Please make checks payable to CFMA and mail to: SELC c/o Colo State Manager Assoc, P.O. Box 40988, Denver, CO 80204
If using Paypal, provide the name on the credit card or account used for payment.
If you need a copy of this form for purchase documentation, please be sure to print BEFORE hitting the submit button.
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If paying by agency check, please list all individuals paid with a single check.
If you need a copy of this form for purchase documentation, please be sure to print BEFORE hitting the submit button.
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