Continuing Education Course - $200

Select Membership Opportunity Select Membership Associate Member - $125 Voting Member - $150 Lifetime Voting Member - $1,800 Agency Membership - $300 I Will Join Later Types of Membership Bail Agency Name (if any): Full Name: Agency E-Mail: Student Address: Bail Agency Address: City, State, Zip: , AL AK AR AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VI VA WA WV WI WY , Agency City, State, Zip: , AL AK AR AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VI VA WA WV WI WY Phone (123-456-7890) | Fax (123-456-7890): Phone: Fax Bail Agency Phone | Fax: Phone: Fax Student E-Mail Address: Available 2010 Courses: Select Course February 21 Sacramento February 24 Los Angeles February 26 San Diego March 1, Palm Desert April 11, Ontario April 20, Burlingame April 21, Modesto June 6, Sacramento June 9, Los Angeles June 11, Santa Barbara Student Social Security #: Bail Agent License Number       Acknowledgments 1 I hereby authorize CBAA to send me via fax or e-mail, information regarding its education program, legislative program, convention, and other pertinent information regarding the bail industry. 2 CBAA does not rent or sell its Membership data. 3 Once you click "Send Continuing Education Registration" the form will send you to the payment page. 4 Auditing a course will not include a certificate of completion. You will need to register for the course that includes certification.