The Association of Information Technology Professionals
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AITP MEMBERSHIP APPLICATION The Association of Information Technology Professionals |
| Please complete all sections of the application. | r | CDP | r | CSP | r | Former AITP Member |
| (PRINT OR TYPE LEGIBLY) | r | CCP | r | ACP | r | Former ASM Member |
| r | CNA | r | CNE | r | Former Student Member | |
| r | Other _______ | r | Former Interim Member | |||
_______________________________________________________________________________________
Name: First
Middle Initial
Last
_______________________________________________________________________________________
Employer Name:
Your Title
Dept/Div
_______________________________________________________________________________________
Employee Address:
City
State Zip
_______________________________________________________________________________________
Home Address:
City
State Zip
Send Mail to:
r Home r CompanyBusiness Phone: _________________________________ Home Phone:____________________________________
FAX:______________________ E-Mail Address:______________________________
Please refer to AITP Dues Reference Guide for Chapter Dues and complete the following, or call "Membership", 708-825-8124 for dues information. A subscription to INFORMATION EXECUTIVE is included with your membership dues.
| Association Dues: | $ 140.00 | Specify Chapter Selected Richmond (44) |
| One Time Processing Fee: | $ 15.00 | |
| Special Interest Groups, EDSIG (optional): |
$ 20.00 | |
| TOTAL | $_________ | Due with this application |
Specify Payment Method:
rVisa r MasterCard r Check r Money OrderCard Number:______________________________________ 3 Digit Security Code on back of Card ______
Name on Card ___________________________________________
I hereby make application for membership in AITP. I agree to comply with the requirements of the Bylaws and Code of Ethics and all regulations adopted by the Association.
Applicant’s Signature:______________________________________________________
Date:__________________
Referred By:_________________________________________________________________________________
Please Mail to: AITP, Richmond Chapter
P.O. Box 26044
Richmond, Va. 23260