TO JOIN, PLEASE DO ONE OF THE FOLLOWING:

Print and complete the form below and

 mail it to IAACI with a check, money order or credit card information

MEMBERSHIP APPLICATION                                       PLEASE FILL IN ALL SPACES

MEMBERSHIP TYPE: _____________________

NAME ________________________________________  TITLE: ___________________________________

MAILING ADDRESS___________________ CITY ___________ STATE ____ ZIP ______ COUNTRY ___ 

TELEPHONE NUMBER ___________________ FAX ____________________ E-MAIL ________________

EMPLOYER _______________________________________________________________________________

ADDRESS _____________________________CITY ___________  STATE ____ ZIP ______ COUNTRY ___

TYPE OF PAYMENT:

 ___ CHECK         ___ MONEY ORDER      CREDIT CARD # _______________________ EXPIRES _____
  • IAACI, P.O. BOX 22825, ST. PETERSBURG, FL 33742-2825
  •                       (813) 878-7368

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