Office use only
Memeber#____
revised 1-11-05

International Association for Identification
Louisiana Division, Inc.
                                                          
                                                                                                                         

MEMBERSHIP APPLICATION                                                                

The Louisiana Division of the International Association for Identification was formed to associate  persons  actively  engaged in  the  profession  of Forensic  Identification, Investigation and Scientific Examination of physical evidence. Thus, the profession and all of its divisions may be standardized and effectively and scientifically practiced.  The Association’s objective is to encourage research, keep members apprized of the latest techniques and discoveries, and to utilize the Association members’ collective wisdom to advance  the  profession of  Forensic  Identification and Crime Detection.

NAME_______________________________________________________________________________

EMPLOYER__________________________________________________________________________                                                                                                                    

POSITION________________________________RANK______________________________________

BUSINESS ADDRESS__________________________________________________________________

CITY_____________________________STATE_______________________ZIP___________________

HOME ADDRESS______________________________________________________________________                                                                                                                   

CITY_____________________________STATE_______________________ZIP___________________

BUSINESS PHONE____________________ FAX_________________   HOME _____________________                        

I am applying for:    [  ] ACTIVE* - $35    [  ] ASSOCIATE** - $40      MEMBERSHIP

*Active Membership shall include all persons and their department heads who are engaged in the science of Forensic Identification, provided, however, that they are bona fide employees of, and receive salaries from, national, state, parish / county, or municipal governments or some subdivision thereof.

**Associate Membership shall consist of all reputable persons, fully or partially engaged in any of the various phases of the science of Forensic Identification, who are not qualified to become Active Members.

          NOTE:    A non-refundable application fee of ten dollars ($10.00 USD) is required with

                           ALL New Member Applications. 

Certification in various fields is offered through the INTERNATIONAL ASSOCIATION FOR IDENTIFICATION.

List, in order, up to three (3) areas of your expertise.  Indicate your PRIMARY DISCIPLINE as number one (1), then other areas as number two (2) and then number three (3).

___Fingerprint Identification                 ___Forensic Art                        ___Bloodstain Pattern Analysis  

___Forensic Photography                       ___ Polygraph                           ___Questioned Documents

___Voice Print / Acoustics                     ___Footwear / Tire Tracks      ___Laboratory Analysis

___General / Innovative Techniques    ___Firearms / Tool Marks       ___Crime Scene Investigation

PERSONAL HISTORY

[Please list degrees, honors and/or other qualifications for membership.]
(Attach seperate page if needed)

 

I understand that application fees paid to the Association by any new applicant between January 1 and September 30 shall be applied to membership for that current calendar year. 

Fees paid between October 1 and December 31 shall be applied to the following calendar year.

All applications must be accompanied by payment of fees, which shall be refunded if application is denied.

NOTE: The membership certificate is the property of the Association, and must be returned to the Secretary upon resignation or suspension.

I certify that all information contained herein is true and correct to the best of my knowledge.  Any omission or falsification of information will be basis for rejection or denial of continued membership.

Applicant’s Signature________________________________________Date________________               
                                          

Sponsoring Member (PLEASE PRINT) ______________________________________________

Sponsoring Member’s Signature  __________________________________________________

Please return to:                 MARIE CAMPBELL, Secretary / Treasurer

                                                5251 Sophie Anne Dr.

                                                Zachary, LA 70791