Membership Application

Established 1973

Annual Fee: $50.00

C/o Glenda Smith
NLSSA Treasurer
Director of Accounting
State Capitol, Room 400
Sacramento, California 95814
(916) 322-0271 FAX (916) 322-9746
glenda.smith@sen.ca.gov

MEMBERSHIP CATEGORIES (Please select one):

____ACTIVE MEMBER Individuals renewing their NLSSA membership and who serve state legislatures as sergeant-at-arms, law enforcement officers, and others in an administrative, service or security related capacity that are not otherwise eligible to join other staff sections of the National Conference of State Legislatures.

____NEW MEMBER Individuals seeking membership for the first time in NLSSA, and who serve state legislatures as sergeant-at-arms, law enforcement officers, and others in an administrative, service or security related capacity who are not otherwise eligible to join other staff sections of the National Conference of State Legislatures.

____ACTIVE ASSOCIATE MEMBER Individuals wishing to renew their NLSSA membership as an Associate Member and who have a peripheral interest in, and who will be of benefit to the association. Associate Members shall enjoy all privileges of the association except voting privileges.

____NEW ASSOCIATE MEMBER Individuals seeking membership for the first time in NLSSA and who have a peripheral interest in the organization and who will be of benefit to the association. Associate Members shall enjoy all privileges of the association except voting privileges.

____ADVISORY MEMBER Individuals serving as elected State Legislators wishing to seek membership in NLSSA. Advisory Members serve on the NLSSA Legislative Advisory Committee and do not have voting privileges in the association.

____Remove my name from NLSSA membership. (email glenda.smith@sen.ca.gov)

BIOGRAPHICAL INFORMATION

Please enclose a black & white photo of yourself if you wish to change your photo in the roster.

Last Name_________________________________________ First Name________________________________________ Initial_____________________________

Title______________________________________________ Organization_________________________________________________________________________

Full Address____________________________________________________________________________________________________________________

Business Phone (_____) ___________________________________ FAX (_____) _________________________________________

E-Mail: _________________________________________________ Home Phone: _______________________________________________________________

Name of Spouse (If Applicable):____________________________________________

Areas of Expertise (i.e. CPR certified, office administration, chamber security, capitol security, page programs, facility management, capitol tours, historic preservation, nurse, EMT, threat assessment, conflict resolution, etc.) ___________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________

If you work in security, are you a commissioned peace officer? ______________

Education (college, high school, special training):
_________________________________________________________________________________________________________________________________________

Professional - Business & Career (positions you have held, professional associations) :
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________

Community (community activities & organizations) :
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________

Awards & Honors (please list any significant awards received and date):
_________________________________________________________________________________________________________________________________________

Military Service:____________________________________________________________________________________________________________________________

Please make checks payable to NLSSA and remit payment to:

Glenda Smith
NLSSA Treasurer
Director of Accounting
State Capitol, Room 400
Sacramento, California 95814

NOTE:

Postmark deadlines for remittance are July 1 and September 1.

Dues received and postmarked on, or before, July 1 will entitle eligible members to be nominated or to seek election to a national or regional office at the NLSSA Annual Training Conference business meeting, pursuant to Article VI, Section 4 (c) of the bylaws of the Association.

Dues received and postmarked on, or before, September 1 will entitle eligible members to vote at the NLSSA Annual Training Conference business meeting, pursuant to Article VI, Section 4 (a) of the bylaws of the Association.

For more information about NLSSA, write or call:

Morgan Cullen, NCSL Liaison to NLSSA

Phone: 303/856-1431
FAX: 303/364-7800
E-mail: Morgan.Cullen@ncsl.org