Illinois College Automotive Instructors Association
Membership Form
Joining ICAIA, one of the nation's premier state automotive technology instructor associations, entitles you to receive our mailings, semi-annual newsletter, and attend any of our spectacular conferences. A conference registration fee will need to be paid to cover additional conference expenses. ICAIA membership dues are only five dollars a year, with one, three and five year options. If you wish to join, just print this form, complete the information, and return it along with a check (No Credit Cards or P.O.'s) made payable to I.C.A.I.A. to:
Art Koudelka
ICAIA Executive Treasurer
Illinois Valley Community College
815 N. Orlando Smith Ave.
Oglesby, IL. 61348-9692
(Please print or type)
Name:_________________________________________________________________
School Name:___________________________________________________________
School Address:__________________________________________________________
City:_____________________________ State:________________ Zip:
_____________
Phone:___________________________ Fax:__________________________________
Cell Pone: ________________________
e-mail:__________________________________________________________________
Home
Address:___________________________________________________________
City:_____________________________ State:________________
Zip:______________
Phone:____________________________ Fax:___________________________________
Where do you want ICAIA mailing sent (circle one) School or Home
Please check all areas that you teach ______Automotive ______Collision ______Diesel
Membership dues are five dollars a year, with a one, three or five year option. Please circle one of the options below:
$5.00 for a one year membership in ICAIA
$15.00 for a three year membership in ICAIA
$25.00 for a five year membership in ICAIA
Thank you.