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C A S -F -M <br />2006 CASFM MEMBERSHIP APPLICATION <br />Membership in the Colorado Association of Stormwater and Floodplain Managers (CASFM) is based on a calendar year Uanu- <br />ary- December 2006). To join the CASFM organization, please complete all relevant information on this application and submit <br />the completed application with your membership fee. All 2005 memberships expire on December 31, 2005. All members in good <br />standing receive benefits including bi- annual newsletters, discounts at conferences and workshops, etc. <br />If you are a RENEWING MEMBER, please specify the type of membership below and proceed to PART 1 of this application. <br />If you are a NEW MEMBER, please specify the type of membership below and proceed to PART 2 of this application. <br />Type of Membership: <br />❑ Individual — $30 ❑ Student — $10 ❑ *Corporate — $150 ❑ *Agency —$150 <br />For your records: Check No. Date paid (All checks must be payable to CASFM) <br />*When signing up for a corporate or agency membership, it is to your company's advantage to include at least five company individuals, <br />but not more that ten company individuals as members. Need more than ten members? just add $15 apiece. <br />PART i — Renewing <br />If you are renewing your membership, please check the CASFM website to verify your company's information. If the informa- <br />tion from the website is correct, please check this box and mail the application to the address below. ❑ If the information <br />from the website is incorrect, please provide the correct information and send it with this application and membership fee to the <br />address at the bottom of this page. <br />Employer /agency: <br />Name of primary contact person for the corporation or agency: <br />Would you like to receive the CASFM newsletter via e -mail or hard copy? ❑ E -mail ❑ Hard copy <br />PART 2 — New Members <br />If you are a new member, please complete the following: <br />Employer /agency: <br />Name of primary contact person for the corporation or agency: <br />Would you like to receive the CASFM newsletter via e -mail or hard copy? ❑ E -mail ❑ Hard copy <br />Member 1 <br />Name: <br />❑ PE <br />❑ PH ❑ CFM <br />❑ CPESC <br />Address: <br />❑ Home <br />❑ Business <br />City: <br />State: <br />Zip: <br />Phone: <br />Fax: <br />E -mail: _ <br />Please check below <br />if member would like to participate on the following committee(s): <br />❑ Floodplain <br />❑ Stormwater Quality ❑ Outreach <br />❑ Scholarship <br />❑ Training <br />Member 2 <br />Name: <br />❑ PE <br />❑ PH ❑ CFM <br />❑ CPESC <br />Address: <br />❑ Home <br />❑ Business <br />City: <br />State: <br />Zip: <br />Phone: <br />Fax: <br />E -mail: _ <br />Please check below <br />if member would like to participate on the following committee(s): <br />❑ Floodplain <br />❑ Stormwater Quality ❑ Outreach <br />❑ Scholarship <br />❑ Training <br />PLEASE MAIL COMPLETED MEMBERSHIP APPLICATION AND FEE TO THE ADDRESS BELOW: <br />Barbara Meier 1 2319 Shadow Ct. I Loveland, CO 80538 1 Tel: (970) 669 -8069 <br />All checks must be made out to: CASFM <br />14 CASFM <br />11 <br />Y <br />