INTERNATIONAL ASSOCIATION OF WORKFORCE PROFESSIONALS

SOUTH DAKOTA CHAPTER MEMBER REGISTRATION FORM

Last Name      First      MI   

Mailing Address     

City     State         Zip  

Telephone      Fax       Email Address     

Place of Employment  Date of Application

*The following is optional and for identification purposes only.*

*Birth Date            

Check One:
($62.00)    ($31.00)

Check One:

 
 

Check One:
 
 

            (Please complete credit card info at bottom of this form.)

Print and Mail completed form and payment, (do not mail cash) to:
IAWP Membership Chair
420 Roosevelt Avenue
PO Box 4730
Aberdeen, SD 57402-4730

 

 

Card Number:      
Expiration Date:     

I hereby authorize the IAWP International to charge the credit card specified above for my IAWP dues (chapter and International portions)in the membership year shown above. I under-stand that the chapter portion of my dues will be returned to my chapter.

Signature_____________________________

Date________________________________