Membership Application

I hereby apply for membership in the Washington City/County Management Association in accordance with their constitution and by-laws. Also, I understand that my submitted application indicates that I have read the ICMA Code of Ethics and agree to abide by them.

First Name:
Last Name:
Partner:
Title:
City/Town/Agency:
Adress:
City:
State:	Zip:
Phone:	( )
Fax:	( )
Email:

Type of Membership

Full MembershipHonorary MemberRetired Member
Associate MemberHonorary Life MemberStudent Member
Affiliate Member

Dues Rate

Less than $60,000 ($45)$90,000 - $99,999 ($121)$130,000 - $139,999 ($153)
$60,000 - $69,999 ($97)$100,000 - $109,999 ($129)$140,000 - $149,999 ($162)
$70,000 - $79,999 ($105)$110,000 - $119,999 ($137)$150,000 + ($170)
$80,000 - $89,999 ($113)$120,000 - $129,999 ($145)