INTERNATIONAL ASSOCIATION OF PERSONNEL IN EMPLOYMENT SYSTEMS
SOUTH DAKOTA CHAPTER MEMBER REGISTRATION FORM
Last Name____________________First______________ Int______
Mailing Address__________________________ City______________ SD, Zip______
Telephone______________ Fax ______________ Email Address_______________________
Place of Employment ____________________ Date of Application _________
*The following is optional and for identification purposes only.*
*Birth Date _______ *Male ___ *Female ___
Check One:
_____Full Member ($62.00) _____Retired Member ($31.00)
Check One:
_____NEW MEMBER (My first year)
_____RENEWAL MEMBER (Member last year)
_____LAPSED MEMBER (I have been a member in the past, but not last year)
Check One:
_____I enclose a check for $62 or $31 payable to SD IAWP.
_____My dues are paid by installment through SODES Credit Union.
_____I wish to pay my dues by credit card, (MasterCard & Visa only).(Please complete credit card info at bottom of this form.)
Mail completed form and payment, (do not mail cash) to:
Tom Meyer
IAWP Membership Chair
420 Roosevelt Avenue
PO Box 4730
Aberdeen, SD 57402-4730
