CITQAA Membership
Enrollment/ Renewal Form
New membership
Membership renewal
**Name:
Phone Number:
Company:
**E-mail:
**Indicates required information for both new and renewing members
Dues and Membership application
Dues are $20 for full members and $5 for associate members. For the benefits of each type of
membership, go to our website www.citqaa.net .
You can apply for/renew membership in one of two ways:
1) Attend a CITQAA meeting and apply in person
2) Email the completed form to citqaa@gmail.com
Professional certifications:
CSQA
CSTE
Other: _____________________________
Please check the following committees you want to participate in:
Programs
Membership
Education
Public relations
Programs - This Committee is responsible for arranging a program or informational presentation for each CITQAA
meeting, recognizing and appreciating speakers and others who have done an outstanding job.
Membership - The Membership Committee maintains membership information for CITQAA and handles checkin/greeter duties for CITQAA meetings. This committee is also responsible for other member-related services such
as directory publishing, library maintenance, and job postings.
Education Committee -The Education Committee is responsible for facilitating professional development and
educational opportunities for members, including certification activities, seminar and training opportunities, and
educational presentations.
Public Relations - The PR Committee is responsible for handling external marketing of the organization and
explaining our organization to the public (brochures, website, mailings, postings, etc.)
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For more information, email us at citqaa@gmail.com
(See other side)
Additional member information (optional)
List any other degrees or non-QAI certifications:
Areas of Interest (check all that apply):
Quality Assurance
Testing
Automation/Tools
Inspections/Reviews
Other (please specify):
Project Management
Metrics
E-Commerce Testing
Process Improvement
Professional Certification
CITQAA will publish a Membership Directory and distribute to CITQAA members only. Only
the biographical information above will be included. Please check here if you do NOT want your
information included in the Directory:
(Checked = please exclude me from the directory)
Please Answer the Following Questions to Help Us Understand Your Needs
Ideas for future meeting topics/programs:
Topics you could teach or present:
How did you hear about CITQAA?
What one thing could we do to improve CITQAA?
Please list any other comments you have regarding the CITQAA chapter: