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Online Dues Payment Form

The IRI membership year is a calendar year, January 1 to December 31. Membership dues for 2011 are $11,450 if paid by 1/15/11 are $11,800 if paid after that date and include two registrations each to the Annual Meeting and to the Member Summit.

Member Company Name:

Address: Address 2:
City: State:
Zip/Postal Code: Country:
Attention To: Phone:
Fax: Email:

We will designate the following persons to represent the company in IRI:

VOTING/PRIMARY REPRESENTATIVE (VR/PR)         ALTERNATE REPRESENTATIVE (R)
Name: Name:
Title: Title:
Company: Company:
Address: Address:
Address 2: Address 2:
City: City:
State: State:
Zip: Zip:
Phone: Phone:
Fax: Fax:
Email: Email:
Website: Website:
Admin: Admin:
Admin Phone: Admin Phone:

2011 Membership Dues $11,450.00
Number of Additional Reps @ $1,100 Per Rep     0
C-Reps @ $600 Per C-Rep     0
Total Membership Dues     $11,450.00