AIAClub Application

Member Form

AIA Membership Dues Form

Dues are for the fiscal year run July 1 through June 30 of the next year

If Paying by Check Please fill out this form, print and mail hard copy with check to:

AIA - 2249 Garland Dr - Birmingham AL 35216

New Member Renewing Member

Full Name Date

Immediate Family Member Names (Attending Meetings)

Address

City State Zip

Home Phone Cell #

Office/Work Phone Email

Amount Paid $ Paid by: Check Online Credit Card Cash (Only at Meeting) Bank Draft

Comments:

	How did you find out about AIA?
	Flyer/Advertising
	Internet
	Friend/Associate
	Don Williams
	Mr. Landlord
	CREonline
	Other
Print and Mail for Check Users
Submit for Credit Card Users

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