Application for Chapter-Only Membership

I understand I am applying for individual membership only in the Chicago Chapter of RIMS. If approved, I will not have access to the added benefits available to full RIMS members as described on www.rims.org. I have read, understand, and agree to support the objectives of RIMS and the Chapter.

Name: *

Email: *

Company: *

Title: *

Work phone:

Phone:

Home

Mobile

Number: *

Preferred mailing address: *

Reason for desiring Chapter-Only membership: *

Category of membership applied for and dues (see definitions at www.rims.org):

Dues are for one calendar year (1/1 - 12/31) and are not prorated. *

Check for dues (if any) will be mailed.

Send invoice for dues (if any) via email following acceptance.

Complete this form on-line, or print and sign personally, date, and submit by mail or email.

Signature: *

clear

Date: +

We will advise you of our decision by phone, email, or letter in 2-3 weeks.

Your Privacy: The Chicago Chapter may use or share your information with third parties as needed to enable you to register for any/or participate in Chapter services and activities. We will not knowingly share your information with vendors or suppliers for marketing purposes.

Submit signed application to:

Maggie Divarco, Chapter Administrator | Chicago RIMS | 318 Half Day Road | Buffalo Grove, IL 60089

Phone: 847-543-4842 Email: mdivarco@comcast.net