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 applying for the IPRF Board of Trustees? *

Yes

No

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

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

IPRF Development Committee

IPRF Finance Committee

IPRF Golf Committee

IPRF Marketing Committee

IPRF Scholarship Committee

None of the above

What IPRF events are you interested in volunteering for? *

This would be day of event assistance only.

IPRF Annual Golf Outing (September)

IPRF Annual Silent Auction (@ Conference)

IPRF Other Events

None of the above