** PRINT, COMPLETE AND MAIL WITH PAYMENT **
September 2009 - September 2010
Annual Membership dues: $60.00
For Students: $10.00
Name:
Title:
Affiliation:
Address:
Telephone
Fax:
E-Mail:
Single Meeting Payment: $20.00
Date of Meeting:
Please make checks payable to: IIPS
Remit to:
Harris Wolin, Treasurer
IIPS
c/o Myers Wolin, LLC
100 Headquarters Plaza
Morristown, New Jersey 07960-6834