Please use the Form below to

Apply On-line for

IFPAC Membership or Services

Name:
Address:
City:
State:
Zip:
Country:
Phone:
Fax:
E-mail:


Select Option:



Membership Opportunities (Select one)

Become an Individual Member ($175.00)
Become a Student Member ($25.00)



Select Payment Method:
for this Transaction

Choose Your Method of Payment
for this Transaction.

Note: Membership will not be conferred until all information is verified
and payment is received.


I will mail a Check to the Business Office
I wish to pay On-Line by Credit Card ( Visa/MasterCard)
     Warning: Submitting Credit Card information via the WWW may not be secure.
     You may choose to phone/fax in your credit card information if so desired.
  • Credit Card Number
    Visa
    MasterCard
    Expiration Date

I will FAX in Credit Card Information to the Business Office
I will Phone in Credit Card Information to the Business Office

Checks must be in US Dollars drawn on a US Bank



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please wait for the acknowledgement form to appear on your screen before continuing.

IFPAC
253 Commerce Dr. Suite 103
P.O. Box 7100
Grayslake, IL 60030
Tel: 847-543-6800 Fax: 847-548-1811
email: ifpac@ifpacnet.org