Please print out form directly off page or save to a file to print later:
ITA Membership & Renewal Form for 20 16Name (please print)______________________________________ Address _______________________________________________ City_________________________State_____Zip______________ Home Phone____________Work Phone________________ Fax Phone _____________Email______________________ Check those that apply: City Resident ( ) Borough Resident ( ) ( ) I am able to help on this committee ________________________________________________ Area of interest:___________________________________ I Want: TOTAL
ENCLOSED __________ Donations and fees are NOT tax deductible under present law. [Print this and Mail to ITA Treasurer, P.O. Box 71892, Fairbanks, AK 99707] |
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