1821 Rutherford Lane, Suite 400
Austin, Texas 78754-5128
Website: txipmahr.org
Membership Period:
Name:__________________________________________________
Affiliation: ______________________________________________
Address: ________________________________________________
City: ___________________ State: _______ Zip Code: __________
Membership Type:
Active
Associate
Membership Fee:
New ($100)
Renewal ($100)
10/01/2016 to 09/30/2017
Member Details:
Title: ______________________________________________________________
Email: _____________________________________________________________
Alternate Email: ______________________________________________________
Office Phone: _____________________
Mobile Phone: _____________________
Please respond to each of the following items:
Are you an IPMA-HR national member?
Yes
No
Do you hold the designation of IPMA-CP?
Yes
No
Do you hold the designation of IPMA-CS?
Yes
No
May we release your name to outside
agencies/vendors/consultants?
Yes
No
If interested, please indicate which Chapter
committee(s) on which you would be
interested in serving:
Membership
Sponsorship
Professional Development
Website
Current Membership Detail
Membership Category
PAYMENT METHOD:
Annual Fee
Professional Membership
Valid: 10/01/2016 to 09/30/2017
$100.00
Company
Personal
Check # ______________________________________
MONEY ORDER ENCLOSED:
Subtotal
$_______
Organization Contribution (Optional)
$_______
Total Due
CHECK ENCLOSED:
$_______
Money Order # ________________________________
To renew your membership online with a credit card via PayPal, please visit:
www. txipmahr.org/membership-application
Mail your membership form and payment to: Texas Municipal Human Resources Association (IPMA-HR Texas)
1821 Rutherford Lane, Suite 400, Austin, TX 78754-5128
For more information, please visit our website at: txipmahr.org