Please complete the Student Membership form below. This is a requirement for FCCMA membership.
Number of Hours:
Estimated Graduation Date:
If yes, ICMA Membership Category:
Have you ever been convicted of a felony or misdemeanor?
If yes, please explain:
Have you ever been denied membership or had your membership revoked in ICMA or any other state association?
Where did you hear about FCCMA?
If you are only enrolled part-time, are you currently working?
If you answered yes, how many hours, your title and name of business or government:
Our membership policy requires that each applicant receive 2 (two) endorsements from full FCCMA members. Please indicate below your two references:
We may contact these persons to verify their endorsement of you.
By my signature below, I certify that the information supplied above is true to the best of my knowledge. I have read and agree to comply with the Code of Ethics of ICMA and FCCMA to the extent that they apply to private companies.