First Name *

Last Name *

Organization *

Geographical Region *

In which IPRA Region is your agency located?

Enter required value Chicago-Metro Northwest Central Southern

Title *

Email *

Are you currently an IPRA Member? *

Enter required value Yes No

Please list any of your past volunteer experience with IPRF, if any:

Are you Interested in being on the IPRF Board of Trustees? *

Yes

No

What IPRF special interest committees are you interested in serving on? *

These positions are for those not already on the IPRF Board of Trustees

Enter required value IPRF Marketing Committee IPRF Finance Committee IPRF Golf Committee IPRF Scholarship Committee IPRF Development Committee None of the above

What IPRF events are you interested in volunteering for? *

This would be day of event assistance only.

Enter required value IPRF Annual Golf Outing (September) IPRF Annual Silent Auction (@ Conference) IPRF Other Events None of the above