IaAWP Membership Registration Form

Please print and fill out the following form to update our records with the most current information. Any information that you do not wish to have published will be duly kept confidential. Dues are $10 yearly or a one time Membership fee is available for $120.  If you attend the Spring Training Conference, your yearly dues are included in the cost of the conference registration.

Send form and dues to the IaAWP Treasurer:

Tiffany Creekmur
c/o Mason City Police
78 S. Georgia
Mason City, IA. 50401

IaAWP Membership Registration Form PDF

Name: _______________________________________________________________

Organization:__________________________________ District: ___________

Org. Address: _______________________________________________________

City: _______________________________ Zip [+4 digit]: _______________

Rank/Job title: _____________________________________________________

Job description: ____________________________________________________

Work Phone: ______________________ ext. __________

Work FAX: ________________________________________

Work e-mail: _________________________ Pager: _______________________

Cell Phone: __________________________

Home address: _______________________________________________________

City, State, Zip: ___________________________________________________

Home e-mail: __________________________ Home Phone: _________________

Please put an asterisk by the information you do not wish published within our organization.

Mailing preference: Work _______ Home _______

Any other aspects of your job, or areas of expertise that you would like included to be used as future resource please list.