2019-20 MnIAAA Membership Registration
NIAAA Member # (if known, if not enter UNKNOWN) *
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First Name *
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Last Name *
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Date of Birth *
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School E-Mail *
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Region *
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Yrs of Service *
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School Name *
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School Address *
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School City *
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School State *
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School Zip Code *
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Payment Method *
The annual MnIAAA Membership fee is $130.00 if payment is by check. If you choose the credit card option, fees are added, your cost will be $135.00. Send check payable to: MnIAAA c/o Mike Beck, 780 Acorn Circle, Monticello, MN 55362. If you would like an invoice or a receipt, please e-mail Mike Beck at beckmb@live.com.
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