Page 25 - NCISS Your Advocate August 2018
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NATIONAL COUNCIL OF INVESTIGATION & SECURITY SERVICES, INC.
“Our Voice in Washington, DC and Across America”
Mail to –P.O. Box 200615, Evans, CO. 80620-0615
Email to – NCISS1976@yahoo.com Fax to – (970) 480-7794
Annual Membership Dues Renewal
Please note: If you joined before June 2015, your dues are based on the calendar year.
If you joined after June 2015, your dues renew annually on your anniversary date.
Please verify that information is current on your NCISS profile.
Visit www.nciss.org/member-search and search your name or login at www.nciss.org/login - you can also pay
your dues online from your profile.
Please complete the following only if you have any changes and submit with your payment:
Member Name: ______________________________________ Agency: ___________________________________________
Mailing Address: __________________________________________________________
City, State and ZIP: ________________________________________________________
Email Address: ___________________________________________________________
Office Phone: _______________________ Cell Phone: __________________________
Amount Due – Regular / Gold Affiliate Associate Service
$175 $175 $75 $250
(Association memberships – please contact Executive Director Karen Beers directly)
NCISS CREDIT CARD AUTHORIZATION FORM
Member Name:
Credit Card No.:
Credit Card: CVV No. Expiration: Billing ZIP:
VISA MC Amex
MEMBER DUES: __________ ( __ REGULAR __ AFFILIATE __ ASSOCIATE __ SERVICE)
LEGISLATIVE DONATION: __________
AMOUNT TO CHARGE: _______________
Please consider a Legislative Fund Donation and a donation of $5 to offset credit card processing fees