CAL-EDA Membership Application

Annual Membership Fee: $35

(After submitting your application, you will be taken to the Payment page)


MEMBERSHIP TYPE: *
 NEW 
 RENEWAL 
First Name *
Last Name *
Email *
Alternate Email
(In case your primary email is blocked or bounces)
Agency Name *
Agency Type *
 Law  
 Fire  
 EMS  
 Other 
Position Held *
Preferred Contact Address *
 Home  
 Work 
Address *

Street Address

Address Line 2

City
State

Zip Code
Country
Phone *

### 		-
### 		-
####
(Indicate below which phone # this is.)
Payment Method *
 Check 
 PayPal* 
(Provide us with your PayPal email address IF different from the email above. This ensures your payment is properly credited.)
*Email Address for PayPal:
Date you first started as a Dispatcher
How many years have you been a Dispatcher
What CAD system do you use?*
What phone system do you use?*
What radio system do you use?*
Additional Information:
(Use this space for anything else you'd like to tell us.)
Image Verification
captcha
Please enter the text from the image:
[Refresh Image] [What's This?]

Stay informed! SUBSCRIBE to our Newsletter!

* Because our members have provided assistance with staffing centers during times of crisis, we are compiling a list of systems currently used by our members in order to help fulfill needs more quickly.