INTERNATIONAL
BUSINESS ASSOCIATION
Membership
Application
Name:
____________________________________
Current
Address: ____________________________
____________________________
____________________________
Current
Phone: _____________________________
Permanent
Address: _________________________
__________________________
__________________________
Permanent
Phone: ___________________________
Fax:
_______________________________________
E-Mail:
____________________________________
Sex: ___________ Graduation
Date: ___________
Major: _______________ Date
of Birth: _________
Home Country/Languages
Spoken (Fluently):
____________________________________________
____________________________________________
Please indicate
whether or not you would like to be part of the
Social/Fundraising
Committee.
Yes:
____ No: ____
_____________________________________________
For
Office Use Only
Dues
Paid: __________ Date: ________ Check: ________ Cash:
_________
Status: ________ Member Number: _____________ Date: __________ Rev 1 Fall 2002