Washington Administrative Law Judges Association

Membership Application

Annual dues for membership in the Washington Administrative Law Judges Association (WALJA) are $50 per member.  Payment of dues entitles you to membership in both WALJA and the National Association of Administrative Law Judges (NAALJ). 

WALJA's fiscal year is July 1 through June 30.  Make checks payable to WALJA.  Mail application and $50 check to WALJA, P. O. Box 6268, Olympia, Washington 98507.

1. Name:_______________________________________________________________

2. Home address:________________________________________________________

______________________________________________________

City, State _______________________  Zip Code __________________

3. Home phone: (    ) ______________________ Work phone: (    ) _________________

4. Agency name: ______________________________________________________

5. Business address: ____________________________________________________

____________________________________________________

City, State ________________________  Zip Code ___________________

7. Home e-mail address: _____________________________________________________

    Work e-mail address: ______________________________________________________

8. WALJA will communicate with you through your home e-mail or send written materials to your home address unless you indicate otherwise:  Please send my mail/email to: Home ____ Work ____

9. Do you serve in the capacity of an ALJ or Hearing Officer _____ full or _____ part-time?

10. Are you interested in being on a committee dealing with issues such as membership, continuing education, communications, social/networking, or other?   

___Yes, I'm interested in working on the following committees:

            ____ CLE & Training                                              ____ Salary

            ____ Administrative Law & Legislative                    ____ Newsletter (New)

            ____ Membership & Outreach                                  ____ ADR (New)

            ____ Social & Networking

11. Do you have any ideas for the organization that you would like the Board to consider?

_____________________________________________________________________________________

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