CITOC MEMBERSHIP FORM

Membership is open to U.S. and International

Court Chief Information and Chief Technology Officers

DATE OF APPLICATION:

FIRST NAME:

MIDDLE INITIAL:

LAST NAME:

SUFFIX:

COURT:

COURT WEBSITE:

POSITION TITLE:

MAILING ADDRESS:

CITY:

STATE/PROVINCE:

ZIP:

COUNTRY: **If outside the United States of America

BUSINESS PHONE:

MOBILE PHONE:

EMAIL:

ELIGIBILITY FOR MEMBERSHIP: (please select one):

Statewide/Province Court CIO/CTO

Single Court CIO/CTO

Appellate Court CIO/CTO

MEMBERSHIP DUES:

$5,000 Statewide or Provincial Jurisdiction Point of Contact (consolidated membership of multiple counties in a state/provincial jurisdiction)

$500 Large Court/AOC (county, statewide, or province) jurisdiction serves a million or more people

$250 Small Court/AOC (county, statewide, or province) jurisdiction serves less than a million people

I am part of a Statewide or Provincial Jurisdiction ($5,000 membership dues already paid)

I am a Deputy/Assistant Director (membership dues include one Deputy/Assistant Director)

PAYMENT:

Please complete and email to: CITOC@NCSC.ORG

Make checks payable to National Center for State Courts (Fed ID 52-0914250).

Payment by credit card, please call 888-609-4023

National Center for State Courts/CITOC 300 Newport Avenue Williamsburg, VA 23185