NCHIA Membership Application
Customer Details:
Title/Name
*
Title
First and Last Name
Agency
*
Agency Supervisor
*
Agency Supervisor Phone Number
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
Choose one of the following requests:
Active Membership (Yes/No)
*
Sworn Law Enforcement Officer with the powers of arrest involved in investigation of death cases. Medical Examiner of NC, Employees of O.C.M.E., District Attorney Investigators assigned to death cases. Non-Sworn employees of N.C.D.O.J., Crime Scene Investigators employed by Local, State or Federal Agencies. Former Sworn LEO's but with qualifications suitable by the Board.
Privileged Membership (Yes/No)
*
Duly elected District Attorneys of NC, U S Attorneys or Assistant U S Attorneys, Police Attorneys employed by a Law Enforcement Agency. Civilians not employed by LEA's that are Professors of an accredited College or University that contribute to the prosecution of Homicides and Civilian Interns of a LEA that contribute to Homicides and have passed a full background Investigation and are recommended by their Agency.
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NCHIA Annual Membership Fee
This fee to be a member of the NCHIA. This membership fee only covers the calendar year in which the applicant paid.
$
20.00
Quantity
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Credit Card
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