CHICAGO CHAPTER
Join OWIT Chicago Today in 3 Easy Steps!
1 – Print Out Application (Right Click – Print – “Only the Selected Frame”)
2 – Fill Out Form
3 – Send Check, Form and Copy of Student I.D., if applicable, to OWIT Chicago
OWIT Chicago Membership Application
I would like the following membership status:
_______ Individual ($75.00)
_______ Corporate ($250.00 – includes 3 individual memberships)
_______ Student ($50.00 – send copy of I.D. with application)
Note: This Membership Status is valid for one year even if your personal status changes.
Please make check payable to OWIT Chicago
Please remit payment to:
OWIT Chicago
P.O. Box 81802
Chicago, IL 60602
Please provide us with both your personal and professional information in order for us to better serve you; however, applications will not be turned away for incomplete information. Information provided may be used for a membership directory compiled for the benefit of our members if that is your preference.
________ Yes, I want my _____ personal / _____ professional address to appear in the membership directory.
________ No, I do not want any information to appear in the membership directory.
Personal Information
Name: _________________________________________________________
Address: _______________________________________________________
_______________________________________________________________
_______________________________________________________________
Telephone with area code: __________________________________________
E-mail: _________________________________________________________
______ I prefer to be contacted at this address and/or E-mail.
______ I do not prefer to be contacted at this address and/or E-mail.
Professional or School Information
Employer or School Name: __________________________________________
Expected Year of Graduation (if applicable): _____________________________
Your Job Title: ____________________________________________________
Address (if different): ______________________________________________
_______________________________________________________________
_______________________________________________________________
Telephone with area code: __________________________________________
Fax: ___________________________________________________________
E-Mail: _________________________________________________________
______ I prefer to be contacted at this address and/or E-mail.
______ I do not prefer to be contacted at this address and/or E-mail.
Topics of Interest to Me:
Geographical Areas of Interest to Me: