IAI Member Update

Members, use this form to make changes to your information in the IAI database. Fields marked in red are mandatory.

PLEASE, submit this form ONLY if you have changes in your name, addresses or phone numbers.

If you leave a field blank, we don't know if that means it has not changed or that it should be removed.

* Member Number:
* Last Name:
* First Name:
Middle Initial:
I want to be removed from the mailing list
for JFI and ID News;
I will access them on the IAI website.
Yes No
Home Address 1:
Home Address 2:
Home City:
Home State/Province:
Home Postal / Zip Code:
Home Country:
Work Title / Position:
Organization / Company / Dept.:
Work Address 1:
Work Address 2:
Work City:
Work State/Province:
Work Postal / Zip Code:
Work Country:
Send IAI mail/publications to: Home Work
List this address in the IAI Directory: Home Work
Home Phone:
Cell Phone:
Work Phone: Extension
Fax:
* E-mail Address:
Are you IAI certified? Yes No
If yes, list discipline you are certified in:
Update your IAI discipline information to:
Comments:
(Please state why you are submitting this.
We get many that have no changes
and we need to understand
the purpose of your request.)
To help stop spam, please answer the following question:
  What is 9 + 4?   The answer is
PLEASE: If you have not entered any changes above, DO NOT click the Submit button