Annual Membership Form
(12 Calendar Months)

CASCWA Membership Descriptions:

• Active: Individuals actively participating in Child Welfare and Attendance or related work.
• Retired: Retired individuals who have participated in Child Welfare and Attendance or related work.
• Student: Individuals enrolled as students working towards a Pupil Personnel Services Credential with CWA emphasis.
• Honorary Life: Nominations are made by the sections for ratification by the State Executive Board.

Section Affiliation

Bay __________ Delta __________ San Joaquin __________ Southern __________

Membership Information

New Member __ or   Renewal __

Date _________________________________________________________________

Last Name _____________________________________________________________

First Name _____________________________________________________________

Address _______________________________________________________________

City, ST & Zip __________________________________________________________

County ________________________________________________________________

Employment/District ______________________________________________________

Title/Position ____________________________________________________________

Your E-Mail _____________________________________________________________