RICAT Application for Membership

Identification Data

Name
Home Address
Home Address
Business Address
Business Address

Education

Employment (2 most recent employers)

Employer #1
Employer #2

Business and Professional Organizations (Include Business Directorships)

Organization #1
Organization #2
Organization #3

Civic, Charitable, Other Organizations (Please list current or recent affilitations)

Organization #1
Organization #2
Organization #3
Select
What do you feel are your strongest areas of expertise based on your background experiences?
Select
Indicate primary areas of interest outside your area of expertise

The following information is optional

Age
Ethnicity
Sex
If you have any questions regarding the application process, please contact Melanie Sbardella at 401.332.9018