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International Consortium
on Governmental Financial Management
Membership Application
1. Enclosed are dues in payment for membership as a (please check
appropriate category):
_____ Sustaining Member ($1,000)
_____ Organization Member ($250)
_____ Organization Member* (150)
_____ Individual Member ($100)
_____ Individual Member* ($50)
2. Organization:
_________________________________________________________
3. Name and Title (individual member/contact
person for sustaining and organization member):
__________________________________________________________
4. Mailing Address:
Street/Post Box ____________________________________________________
City ______________________________________________________________
Province/State ______________________________________________________
Postal/Zip Code and COUNTRY ________________________________________
5. Telephone: ___________________________
Fax: ___________________________
6. Email/Internet: _________________________________________________________
7. Visa or Mastercard number:___________________________
Expiration Date: ___________________________
* A special discount is offered to
developing countries, countries with economies in transition and
regional groups/organizations in such countries to encourage their
participation. This discount is available to all countries other
than Australia, Canada, China, Egypt, European countries (except
transition economies) India, Iran, Israel, Japan, Kuwait, Libya,
Mexico, New Zealand, Nigeria, Oman, Saudi Arabia, United Arab Emirates,
USA, Russia, and Venezuela.
Return this page via FAX, email, post with your payment
to:
FAX: (703) 624-5473
Post:
International Consortium on Governmental
Financial Management
2208 Mount Vernon Avenue
Alexandria, VA 22301-1314
USA
Email: icgfm@icgfm.org
If you have questions, please call
the ICGFM at (703) 562-0035 or email.
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