Street Address (for UPS purposes):
Please send an invoice for payment. I understand that until payment is received, my company's joint membership is not completed.
At this time we do not accept credit cards via the internet. However, if you prefer to pay by credit card please print this application, write your card number, the name on the card, and expiration date at the bottom and fax to: 515.276.8038. Attention: Terri Simmons If paying by check please submit the form and mail your check indicating the date you registered on line. You may also submit this application for pre-registration and indicate if your company needs to be invoiced prior to payment, however in all cases, you will be considered registered as a member when payment is received.
Remit payment to: Iowa-Illinois Safety Council 8013 Douglas Avenue Urabandale, IA 50322 Phone: 515.276.4724 Fax: 515.276.8038 E-Mail: iiscadmin@iisc.org
