Professional Investigators of California

• student
• service & industry
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Please fill out the form below so that your information can be processed and added to the PICA Investigator database.
You will be prompted to make your payment in the final step.

Please provide only the information as you would like to see it appear in the PICA membership directory and online directory.

Note: Fields with an asterisk are required. The form cannot be submitted without completing all required fields.

*Name:

*PLEASE INDICATE
YOUR STATUS:

NEW MEMBER
RENEW MEMBERSHIP (please fill out form entirely)

Company (as it appears on your license):

PI License #:

State/Jurisdiction:

Issue Date:

Expiration Date:

*Address:

Website:

*E-mail:

*City:

*State:

*Zip Code:

*County:

If above is a P.O. Box or PMB, please provide a street address for personal deliveries:

*Business Phone:

2nd Business Phone:

Fax Number:

Cell Phone:

Pager:

Date of Birth:

District Affiliation (California only):

Northern
Bay Area
Central Coast
Los Angeles
Orange
San Diego
Inland Empire

*Member Status:

If you are unclear as to which member status you are, click here.

active
associate
service & industry
student

Specialties:

Background Investigation
Civil
Criminal
General
Insurance Adjusting
Surveillance
Worker's Comp
Workplace Investigation

Other :

Background:

Education Years

Fed Government Years

Law Enforcement Years

Military Years

On the Job Years:

Other :

Languages:

	Spoken	Read
French
German
Italian
Spanish
Other(s)

*I hereby apply for membership to the Professional Investigators of California Association (PICA). I authorize representatives of PICA to make a complete and thorough review of my application. I understand that the information in this application will be available for publication unless otherwise noted. I understand that submitting false information on this application will result in denial and/or revocation of my membership. I agree to abide by the Bylaws, Code of Ethics, Standing Rules and all amendments approved by the members of PICA.