February 2012

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2012 Financial Dues Information

Financial dues online - remember to complete the membership form below and then click on the link to pay online. If you unable to click the link then paste the link in your browser.

http://iotagammaomega.org/membershipdues2012.html

2012 Membership Dues
Name
Email Address
Phone Number
First Name
Middle Name
Last Name
Financial Card #
Street Address
City
State
Zip Code
Preferred Email Address
Home Phone
Cell Phone (optional)
Work Phone (optional)
Initiation ChapterMonth/Year
Occupation
Birthday (Month/Day)
2012 Membership Dues Structure	Golden Member (Not Life) - $268.15 Golden Member (Life) - $175.45 New Graduate Member - $180.60 Reinstating Member with COIP - $513.30 Reinstating Member- $309.35 Renewing Member (Life) - $185.75 Renewing Member (Not Life) - $278.45
Personal Automobile Insurance	No Yes