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NATIONAL ASSOCIATION OF COUNTY SURVEYORS APPLICATION FOR MEMBERSHIP   Name:   Title:   Address:       Phone:   Fax:   Email:     Please provide the following information:   1. Are you a member of a statewide County Surveyor (or comparable) organization?    Yes [ ]   No [ ]   2. If yes, please provide the following information: Name:   Title:   Address:         3. Are you a licensed surveyor? Yes [ ] No [ ]   4. How large is your county? Sq. miles: ______________ Population: ___________   5. How many counties in your state? ______________   6. Are you a public land state? Yes [ ] No [ ]   Please return your completed application and check in the amount of $50.00 to:   National Association of County Surveyors R. Charles Pearson, PLS County Surveyor Clackamas County 9101 SE Sunnybrooke Blvd, Suite 428 Clackamas, OR 97015-6612   Phone: 503-353-4499 Fax: 503-353-4481 Email: chuckpear@co.clackamas.or.us

NATIONAL ASSOCIATION OF COUNTY SURVEYORS Dues Notice Full Member Annual Dues are $50.00 Associate Member Annual Dues are $25.00   Name:   Title:   Address:   City:   State/Zip:   Phone:   Fax:   Email:   County:     Mail dues to: National Association of County Surveyors R. Charles Pearson, PLS County Surveyor Clackamas County 9101 SE Sunnybrooke Blvd, Suite 428 Clackamas, OR 97015-6612   Phone: 503-353-4499 Fax: 503-353-4481 Email: chuckpear@co.clackamas.or.us