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This application
“MUST” be complete to be accepted – no exceptions.
Payment (check or money
order) must accompany your application.
New
Membership in International ($75.00) & Indiana
Chapter Membership ($20.00) Total $95.00
I hereby make application for
membership in the International Association of Arson Investigators, Inc.,
and/or membership renewal in the Indiana
Chapter, Inc. of the
International Association of Arson Investigators, Inc., in accordance with
their Constitution and By-Laws, and agree to be
bound therewith. All
information given by me is warranted to be true.
Personal Information
Name (Last, First, Middle
Initial)_______________________________________
Date of Birth
_________________
Home
Address _______________________________________________
Last four digits of your
social security # __________
City___________________ State/Province ____
Zip/Postal Code_________ Country ______
Home Telephone
( ) ________________
E-mail Address:
____________________________________
Employer
____________________________________ Supervisor________________________
Business Address
______________________________________________
City
____________________State/Province ____ Zip/Postal Code _________ Country______
Business Telephone
( ) ____________ Fax No.
( ) ________________
Are you already a member of
the International Association of Arson Investigators?
Yes No
Your IAAI Membership
Number ______________
Occupational Affiliation
(circle one)
Public Service
Private
Investigation Insurance
Engineering Scientist/Laboratory
Legal
Primary Duty (circle one)
Fire Investigator
Forensic accountant Chemist/Scientist
Manager Instructor Attorney
Forensic Engineer
___________________________ Other
__________________________
(Discipline)
(more on page 2)
International Association of
Arson Investigators, Inc.
Application for Membership
(Page 1 of 2)
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