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We want
you in IVI-IPO where you can help set the direction
of politics in Illinois! In order to become a member
just print this page, fill out this membership application, checking the
membership category you have selected.
Make checks
payable to IVI-IPO and send to: |
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IVI-IPO
1325 S. Wabash, Suite 105
Chicago, IL 60605
Printable Adobe Acrobat Document [PDF] |
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Name:_______________________________________________________
Address:_____________________________________________________
City:__________________State:______Zip:_________________________
E-mail:_______________________________________________________
Home Phone:_____________________Business Phone:_________________ |
Circle
your membership level:
Individual - $35.00 Joint (2) - $50.00 Share
the Cost - $88.36 Contributor - $125.00
Benefactor - $250.00 *
LIFETIME - $1000.00 Limited Income - $15.00
*
The lifetime membership is a one time membership fee. It includes
one free admission to all IVI-IPO events
for one year and one free ticket to the Independents' Day Dinner for the first
five years.
Contributions to IVI-IPO are not tax-deductible
I would
like to participate in:
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Work
__Volunteer in office
__Community Action
__Legislative Action |
__National
Affairs
__Finance/Fundraising
__Membership Development
__Public Relations |
__Political
Resources
__Gay & Lesbian Caucus
__Women's Caucus
__Newsletter Production |
Your Home For Good Government Since 1944
IVI–IPO, 1325 S. Wabash, Suite 105, Chicago, IL 60605, Voice: 312-939-5105,
Fax: 312-939-3315 e-mail: info@iviipo.org
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