Membership Application

Member Information
First Name:		Last Name:
Title:
Address:
City:		State:	Zip:
Home Phone:	Work Phone:				Ext:
Email:
Company Name:
Company Address:
City:		State:		Zip:
IIBA Membership Number:

	Volunteer Availability
		Please indicate which committees you are interested in volunteering
___ Membership			___ BA BOK study group
___ Event Planning			___ Event Speakers
___ Web/Newsletter			___ No preference but would like to help

Officer Interest

If you are interested in running for an office please indicate which office:

___ President

___ Secretary/Treasurer

___ VP – Communications/Marketing

___ VP – Professional Certification

___ VP – Membership / Professional Development

You will be contacted after the meeting to supply a bio. Organizational meeting will be held in August to prepare for the Annual General Meeting.

Annual General Meeting where elections will take place will be in October.

Membership dues are $25 per year.

Please return membership application and make checks payable to IIBA – NJ chapter and submit to Sharon Ashton - 202 Hall Mills Rd, Whitehouse NJ 08889 or

Dee Walsh – 15 Mountainview Rd Warren, NJ 07059.