MARIN CHAPTER, CALIFORNIA GRAND JURORS’ ASSOCIATION

P.O. Box 4274, San Rafael, CA 94915

MEMBERSHIP APPLICATION

The Chapter’s commitment to its members:

Neither the Chapter, nor its elected or appointed officials will share your name, telephone number or postal or email address without your permission. By completing this application and/or by paying your dues, unless Chapter dues for your membership category are not required, you are consenting to the use of the personal information provided, for the purpose of contacting you on matters related to business of the Chapter including, but not limited to, compliance with California Corporations Code 6330, et seq.

1. Are you a member of the current or immediately preceding year Marin County Regular (Civil) Grand Jury?

Yes _______ No ______. [Members of these juries are not required to pay chapter dues in the current year]

2. If you are a member of any other Marin County Regular (Civil) Grand Jury, membership dues are $20 per yr.

[Note: Please complete a check for $20 payable to Marin County GJA and include it with your application]

3. Please provide the following information as it applies to you: [please type or print legibly]

a. Name __________________________________________________________________________

b. Postal Address ___________________________________________________________________

City ____________________________________________ State ___________ Zip ____________

c. Email Address ___________________________________________________________________

d. Phone numbers, Home __________________ Business _______________ FAX ______________

e. New member _________ Associate member _________ Renewal _________

f. Years of Jury service [please indicate if your service was, Calendar year, Fiscal year or 18 month]

Calendar Year [e.g. 1983] ___________________ __________________ _________________

Fiscal Year [e.g. 2002-2003] __________________ ___________________ _________________

18 month term [e.g. Jul 02 – Dec 03 or Jan 02- Jun 03] __________________________________

g. Are you a member of CGJA, the state association? Yes ____________ No _________________

4. The CGJA BOD at its 2/26/07 meeting approved lifting dual membership requirement relative to member voting rights. In the April Journal President Lazenby indicated that the CGJA Board has vacated the dual membership requirements for all Chapters. Implementing policy has not yet been promulgated and therefore the impact is unclear. What is clear is that there will be a change in policy. When instructions have been received, the Chapter will provide that information to its membership along with the impact upon our membership structure.

5. Please print out this form, complete the requested data, and mail the completed form and check to:

Marin Chapter CGJA, P. O. Box 4274, San Rafael, CA 94903