ࡱ> ?A>% |bjbj%% ?GGxl 8 4{D $ v B|"  65@   (z. $K0{U@U  MEMBERSHIP APPLICATION Official RMDIAI Website: www.rmdiai.org Name of Applicant______________________________ Attach 2x2" photo Date of Application_____________________________ here I would like to be considered for membership in the ROCKY MOUNTAIN DIVISION of the INTERNATIONAL ASSOCIATION FOR IDENTIFICATION as an: Active Member ____ Associate Member____ ACTIVE MEMBER: The active membership of this Division shall consist of persons who are engaged in the science of identification and forensic science, heads of police departments, or chiefs of detectives and sheriffs; PROVIDED HOWEVER, that the foregoing persons are bona fide employees of, and receive salaries from national, state, county or municipal governments, or some subdivision thereof An active member shall not lose his or her active status because of retirement or change of assignment so long as he or she remains in good standing. ASSOCIATE MEMBERSHIP: All reputable persons, wholly or partially engaged in the various phases of the science of identification, and who are not qualified for active membership, are hereby eligible to become Associate Members. They shall, in all respects, be subject to the same rules, fees, and charges, and will be entitled to the same rights and privileges as active members, except they shall not be entitled to be elected to the office of President or Vice President. State your qualifications for membership: (Before answering, be sure to read the qualifications for membership as listed above.)    I understand that annual dues are $20.00 payable on application, and are then due January 1st of each year thereafter. Please make checks payable to RMDIAI. Ive included $5.00 for a lapel pin. ___________(Optional) _______________________________________ Signature All information requested on this form must be provided or marked "Not applicable". Failure to provide the requested information will be cause for the return of this application. Mail to: Wendy Kipple, Treasurer PO Box 1442 Fairplay, Colorado 80440 MEMBERSHIP APPLICATION Name __________________________________ Date and Place of Birth _____________/_________________ Employer ___________________________________Title__________________________________________ Office Address ______________________________Office Phone ( )______________________________ City __________________________ County____________ State_____________Zip______________________ Home Address _____________________________________ Home Phone ( )_______________________ City__________________________ County ____________ State ____________Zip______________________ Employment Reference: Supervisor/Other Title: ___________________________________________________ Name ________________________________________________________ Address ______________________________________________________ Phone ( )_______________ City___________________________________________State __________________ Zip__________________ Have you ever been convicted of a crime?_______ If Yes, give details__________________________________ __________________________________________________________________________________________ Degrees, Honors and Certifications (include certifying organization)?___________________________________ __________________________________________________________________________________________ Please indicate up to three of the following disciplines (numbers 13 with primary discipline as number 1) in which you are involved: __Fingerprint Identification __Forensic Art __Voice Print & Acoustics __Crime Scene Investigation __Polygraph __Questioned Documents __Laboratory Analysis __Forensic Photography __Firearms & Toolmarks __Footwear and Tire Tracks __Bloodstain Pattern Analysis __Forensic Anthropology __Forensic Odontology __Forensic Entomology __Innovative/General Techniques Other (Specify)_________________________________________________________________________________ Where do you prefer to receive your mail? __Home Address __Business Address Which address do you want published in the directory? __Home Address __Business Address Email/Web page?___________________________________________________________________________ Recommended by_______________________/____________________________Member's Number ________ (RMD Member s Signature & Printed Name) Board reading approved______________________________Disapproved______________________________ (Date) (Date) Signed by__________________________________________ (Board Chair) Rocky Mountain Division of the International Association for Identification A non-profit organization chartered in 1967 for the purpose of educating law enforcement professionals in the Colorado-Wyoming area in the forensic sciences. *+,U      J k l wz{u|ž CJOJQJ CJ OJQJ CJ,OJQJ#j5CJ$OJQJUmHnHuCJjUmHnHu CJOJQJCJ jCJUCJ*+TU6]^   2 &d P  2     2" 2l  $ 2l a$x{        C D  + H I J   ^ 2  E 2   2 &d P J k l + , WXZ[  2tg! 2v! 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