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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.