revised 3/08/2010

MEMBERSHIP APPLICATION - Download Membership Application here!
or Print this page, fill in the blanks and submit with payment to: Code Enforcement Association of Texas,
Attn: Lupe Guerrero, CEAT Treasurer, P.O. Box 28476, San Antonio, Texas 78228.
CEAT does not accept credit cards or purchase orders, only checks, money orders and/or cash.

Date: ____________________________

Name: _______________________________________________________________________________________

Mailing Address: _______________________________________________________________________________

City, State, Zip: _________________________________________________________________________________

Employer/Agency: ______________________________________________________________________________

Dept. or Division ___________________Position/Title: _________________________________________________

Phone (with area code): __________________________________________________________________________

Email: ______________________________________  Alternate Email: ____________________________________

DSHS Registration # CE__________________________________________________________________________

DSHS Registration expiration (MM/YY) ______________________________________________________________

County (working in, not residing in) _________________________________________________________________

Referred by: ___________________________________________________________________________________

Signature: ____________________________________________________________________________________

Select One:  New Membership    Renewal
Circle One:
   $40 Active         $40 Associate           $100 Member Agency

Please note that Membership Agency does not include individual memberships. If you are interested in volunteering for the Membership Committee, please contact Terri Thurman, City of Dallas by email at ceat3vp@ceat1.org or call (214) 773-2668.
***PLEASE NOTE:  Membership term is October 1 through September 30 of each calendar year***