California Clerk of the Board of Supervisors Association

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Registration
Name:
Username:
E-mail:
Password:
Verify Password:
Phone #:
Fax #:
Site Address:
Site City:
Site State:
Site Zip Code:
Mail Address:
Mail City:
Mail State:
Mail Zip Code:
Dept. Name:
Region:
CCBSA Member:
Primary CCBSA Contact Person:
CCBSA Officer:
County Website:
Dept. Website:
Birthday mo/day:
County:
Number of Staff:
Title:
Department Head:
Report to:
Salary:
Additional Compensation:
Agenda Responsibility:
Number of BCCs:
County Population:
Manage BOS:	Yes No
At Will:	Yes No
Date Completed:
Other:

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