ILLINOIS PROBATION AND COURT SERVICES ASSOCIATION

 

                           

MEMBERSHIP APPLICATION

 

Members are the backbone of this Association and your interest in becoming a member is appreciated.  IPCSA has an active membership of over 1,000 members and is considered one of the largest state probation associations in the U.S.  (Completing all of the requested information will ensure that you receive all future mailings to the correct address.)

 

MEMBERSHIP YEAR________                    q First Time Member $20.00                             q Membership Renewal $40.00                

Name:______________________________________________               Position/Title:_____________________________

 

County and Department Name:__________________________________________________      Circuit_____________

 

Mailing Address: ___________________________________________________

 

                                   ____________________________________________________

 

                                   ____________________________________________________

                                                                   

Daytime Phone #:  (          ) ______________________             E-mail Address:__________________________________

 

 

 

 

Membership Fee Paid For By:

 

q Department               q Applicant                   Have been an IPCSA Member since:__________

                                                                                                                                                          

My Job Function Falls in the Following General Categories:

 

q Adult Probation  qPretrial Services  q Juvenile Probation   q Juvenile Detention    q__________________

                                                                                                                                                                                       (Other)

My Position Falls in the Following Category:

 

q Director    qChief Managing Officer    q Supervisor    q Line Officer    q AA/Office Manager    q Support Staff

 

I Am Interested in Learning More About the Following Committee(s):

 

q Awards Committee                                                                        q Nomination/Election Committee

q Community/Public Service Committee                                      q Pretrial Committee

q Day/Evening Report Center Committee                                    q Program Committee

q Detention Committee                                                                     q Resource Committee

q Domestic/Family Violence Committee                                      q Special Services/Sex Offender Committee

q Gender Responsive Committee                                                   q Substance Abuse Committee

q Legislative Committee (CMO approval required)                  q Victim Services Committee

q Membership Committee                                              

 

Please send this application with your membership dues, made payable to IPCSA,  to the following address:

 

IPCSA

P.O. Box 8826

Springfield, Illinois 62791-8826

630/969-6956 (phone & fax)