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Membership Update - Active and Non-Commercial Associates

 

NCTR Current Members:

Please take a moment to fill out our Membership Update form below. This information will be used to print our 2010 Membership Directory as well as update our Member database. Completion of this form by December 14, 2009, is most appreciated.

If you have any questions, please contact the NCTR Office Manager, Robyn Gonzales, via email or by phone at (916) 394-2075.

Thank you for your timely completion of our Membership Update form.

MEMBER NAME:

Please enter how you would like your System's name to appear in the NCTR printed membership directory as well as on the NCTR Website:

Member Name

Website Address

MEMBER CONTACT INFORMATION:

Please note: the contact name and phone number will be posted on the NCTR website. We will not link your email address.

Director or CEO Name (First and Last)

Title

Email Address

Phone Number

Fax Number

Assistant's Name (First and Last)

Email

Phone Number

 

MEMBER ADDRESS INFORMATION:

Physical Address:

Address

Address

City

State

Zip Code

Mailing Address (If different than physical address):

Address

Address

City

State

Zip Code

PORTFOLIO INFORMATION:

In House

External

Total

As of (Enter Date)

Portfolio Notes

ENROLLMENT INFORMATION:

Active

Inactive

Annuitants

Total

As of (Enter Date)

Enrollment_Notes

STAFF LISTING:

NCTR will print up to 8 staff names in the Member Directory. This is not mandatory and is at the descretion of the Member.

#1. Name

Title

Division

Email

Phone Number

2. Name

Title

Division

Email

Phone Number

3. Name

Title

Division

Email

Phone Number

4. Name

Title

Division

Email

Phone Number

5. Name

Title

Division

Email

Phone Number

6. Name

Title

Division

Email

Phone Number

7. Name

Title

Division

Email

Phone Number

8. Name

Title

Division

Email

Phone Number