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2019 Iowa IAI Educational Conference and Business Meeting Registration
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Email
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Name
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Agency/Employer
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Address
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City/State/Zip Code
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Name of Person Attending
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Membership Status
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I am a current member, please extend my membership through 2020
I am a Lifetime member and qualify for the discounted conference rate of $65.00
I am not a current member but plan on submitting an application form before or at the conference
I will be attending the conference but am not interested in becoming a member
I am a student and qualify for the discounter rate of $45.00. Please bring proof of enrollment.
Payment Type - Payment must be submitted prior to the conference unless arrangements have been made.
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Payment will be mailed to Cortney Watson, 22 North Center Street, Marshalltown, IA 50158
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A copy of your responses will be emailed to the address you provided.
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