Membership Renewal Form

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Membership Renewal FormCourtney Coe2024-05-03T12:05:18-05:00

Membership Renewal Form Central Illinois Municipal Clerks Organization

(Please submit one form for each individual)

Member Information:

First Name *

Last Name *

Municipality *

Have your job details changed since last year? (when you last filled out a membership form) *

If your title, municipality, address, email, phone number, or other details have changed, choose 'yes'

Yes

Population

Results of the most recent census, or an estimate

Business Address

City, State & Zip Code

City, State and Zip Code

Title *

Title (Other)

specify 'other' title

Position Held Since: *

What year were you hired, appointed, or elected to your current position

Elected/Appointed

Elected

Appointed

Status *

Business Phone *

Business Email Address *

Do you need to add or change your personal address or contact information? (Note this is for internal use only) *

This is especially important for honorary members, or for those that change municipalities/careers, so CIMCO can keep in touch

Yes

Personal Address

City, State and Zip Code

Personal Phone

not required

Personal Email Address

Are you transitioning to become an Honorary Member? *

Active Members who retire from being a Clerk, Deputy Clerk, or Assistant Clerk

Yes

Let us know when your planned retirement date is, and PLEASE make sure your personal contact information is on file with CIMCO so we can keep in contact with you! Congrats on your retirement, and we hope you will still have time to participate in our organization.

An approximate date is fine if not sure yet

Membership Details:

I am a member of the following Clerks organizations:

Municipal Clerks of Illinois (MCI)

International Institute of Municipal Clerks (IIMC)

Another Regional Clerks Organization

None of the Above

What other Regional Municipal Clerks organization are you a member of?

I am interested in serving as a CIMCO Officer.

Yes

I am interested in learning more

Officer Positions

Details on each position can be found in the CIMCO Bylaws

Treasurer

Secretary

Vice President

President

I am interested in serving on a CIMCO committee during the next fiscal year.

Yes

I am interested in learning more

Committees

Details on each committee can be found in the Standing Rules of the CIMCO Bylaws

By-Laws Committee

Membership Committee

Auditing Committee

Scholarship Committee

Program Committee

Mentor Committee

Communications Committee

Website Committee

Nominating Committee

I am willing to host a CIMCO Meeting during the next fiscal year.

CIMCO Officers and the Programming Committee are available to assist with the needs for CIMCO Meetings

Yes

I would like more information

There are topics related to Clerks duties that I would be interested in learning more about.

Yes

List some topics you are interested in

Provide preferred months to host the meeting and/or programming topics, if you have a preference or suggestion.

Click Here for Information on Municipal Clerks Organizations

CIMCO Bylaws

Final Step:

Annual Dues in the amount of $30.00 shall be sent to the CIMCO Treasurer prior to October 1st.

Make checks payable to: CENTRAL ILLINOIS MUNICIPAL CLERKS ORGANIZATIONS (CIMCO)

Annual Dues Acknowledgement *

I have sent or will send the annual dues, and I understand that without receipt of payment my application will be considered incomplete.

Annual Dues Waiver (Honorary Members)

Annual Dues are not required for Honorary Members. See the Bylaws for additional details.

I wish to submit this Membership Renewal Form for the Central Illinois Municipal Clerks Organization, and I declare my status as a duly elected or appointed Municipal Clerk, Deputy Clerk, or Assistant Clerk in the State of Illinois, and I am currently an Active Member of CIMCO.

Signature

If you wish to physically sign the application form, please download the PDF document and follow the instructions.

By checking this box, I am certifying the provided information is true and waive the signature

Date of Submission *

Today

Thank you for submitting your Membership Renewal Application to CIMCO!

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