tcsa_nc_regular application

TRAFFIC CONTROL SUPERVISORS ASSOCIATION
APPLICATION FOR MEMBERSHIP AND DUES NOTIFICATION

January 2002 to December 2002

AGENCY:____________________________________________________________

ADDRESS: _____________________________________________________________________

CITY: _______________________________ STATE:____________________

ZIP: ____________________________ WEB PAGE: __________________________

[ ] RENEWAL [ ] NEW MEMBER

NAME: _______________________________ TITLE:__________________________

EMAIL:________________________________

TELEPHONE: (_____)__________________ FAX: (_____)_____________________

Responsibilities:

[ ] Markings [ ] Signs [ ] Purchasing [ ] Street Maintenance [ ] Misc./Other

USE REVERSE SIDE FOR ADDITIONAL MEMBERS

FEES: Regular Member (Public Agency Employees): $15/Person

Total Enclosed: __________

Return to: Traffic Control Supervisors Association
Northern California Chapter
P.O. Box 67088
Scotts Valley, CA 95067-7088

**RETURN BY December 31, 2001**

This Association has been formed for the following purposes:

To provide a means and environment for exchange of ideas and knowledge for mutual benefit.

Through association, to keep abreast of latest mechanical and technical developments of material and tools

To meet periodically for the purpose of discussing subjects of general or specific interests, which may be traffic painting, curb painting, traffic control signs, or general traffic control problems.

        President:           George Reynolds                          Director:             Larry Hagen
        Vice President:   Craig Nielsen                                Director:             Anthony Garcia
        Secretary:           Denis Kong                                   Vendor Rep.       Ed Vodegel(Flint Trading)
        Treasurer:           Waver Garrett                                Past President:   David Ferguson

Northern Home Page Membership Dues

	To provide a means and environment for exchange of ideas and knowledge for mutual benefit.
	Through association, to keep abreast of latest mechanical and technical developments of material and tools
	To meet periodically for the purpose of discussing subjects of general or specific interests, which may be traffic painting, curb painting, traffic control signs, or general traffic control problems.