GREATER KANSAS CITY CHAPTER
CHAPTER ASSOCIATE MEMBER APPLICATION
October 2015/2016
New: 
Renewal:
DATE: ________
NAME:____________________________________________________
MAILING ADDRESS:
_____________________________________________________________________________________________________________________________________________________________________________________________
E-MAIL: __________________________________
EMPLOYER: __________________________________________
EMPLOYER WEB SITE: ________________________________
OCCUPATION: ________________________________________
TELEPHONE: ______________________ Fax: ____________________
SIGNATURE: ____ ___________________________________
PAYMENT METHOD
Chapter Associate Membership - $45.00 per individual
[Application will be processed upon receipt of payment.]
Credit card payments are accepted, if paying by check, make payable to:
Greater Kansas City RIMS Chapter
Remit app and payment to:
Laura Vunovich
HNTB Companies
See margin for contact details
