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									                                                    AIA Chicago
                      2010 Professional Affiliate Firm Membership Application

AIA Chicago Affiliate Firm membership is open to non-architecture firms specializing in areas related to architecture. Up to
three individuals per firm may subscribe to mailings and receive membership benefits within a single Affiliate Firm
membership, with additional individuals having the option to join as individual Professional Affiliates at a discounted rate.
Below is an outline of the membership:

            The annual dues cost is $500.00 (individual Professional Affiliate membership is $225.00). Multiple-year
             memberships are offered for two- and three-year terms, for the further discounted rates of $950.00 and
             $1400.00, respectively.
            Membership entitles each affiliate firm to use the phrase, “Affiliate AIA Chicago” in its communications.
            Up to three employees in each firm are entitled to member benefits: discounted rates for program attendance,
             discounts on documents and other publications, member rates on mailing list purchases and Web site listings,
             and subscriptions to the Chapter newsletter and mailings.
            Each additional individual per firm wishing to join as a Professional Affiliate may do so at a reduced dues rate
             of $175.00 annually.
            One primary contact, designated on the application, will receive the membership renewal invoice, and will be
             responsible for dues payment. The primary contact may be changed at any time.

Please complete the following information for the Primary Contact.


Mr / Ms (circle one) Name                                                                            Date of Birth

Home Address

City                                                   State                                Zip

Business Name

Business Address

City                                                   State                                Zip

Daytime Telephone                                      Fax                                  Home Telephone

E-mail                                                                   Send all mail to: ____Home ____Business


Second Contact (if applicable):

Mr / Ms (circle one) Name                                                                            Date of Birth

Home Address

City                                                   State                                Zip

Business Name

Business Address

City                                                   State                                Zip

Daytime Telephone                                      Fax                                  Home Telephone

E-mail                                                                   Send all mail to: ____Home ____Business
Third Contact (if applicable):

Mr / Ms (circle one) Name                                                                        Date of Birth

Home Address

City                                                 State                               Zip

Business Name

Business Address

City                                                 State                               Zip

Daytime Telephone                                    Fax                                 Home Telephone

E-mail                                                                Send all mail to: ____Home ____Business

Dues Rates:
Membership terms are based on the calendar year; however, as new members may join at any time, dues are
prorated by quarter. Below are the dues amounts for firms:

Single-year membership:
Join date from 10-01-2009 through 03-31-2010                          $500.00 – receive benefits through 12-31-2010
Join date from 04-01-2010 through 06-30-2010                          $375.00 – receive benefits through 12-31-2010
Join date from 07-01-2010 through 09-30-2010                          $250.00 – receive benefits through 12-31-2010

Two-year membership (only first year is prorated):
Join date from 10-01-2009 through 03-31-2010                         $950.00 – receive benefits through 12-31-2011
Join date from 04-01-2010 through 06-30-2010                         $825.00 – receive benefits through 12-31-2011
Join date from 07-01-2010 through 09-30-2010                         $700.00 – receive benefits through 12-31-2011

Three-year membership (only first year is prorated):
Join date from 10-01-2009 through 03-31-2010                         $1400.00 – receive benefits through 12-31-2012
Join date from 04-01-2010 through 06-30-2010                         $1275.00 – receive benefits through 12-31-2012
Join date from 07-01-2010 through 09-30-2010                         $1150.00 – receive benefits through 12-31-2012

Each additional member (4 or more) - $175.00 per member.

I, the undersigned, hereby apply for my firm’s admission to AIA Chicago as an Affiliate Firm Member, and wish
to be the primary contact, responsible for payment of the firm’s membership dues.


Primary Contact Signature                                                                Date

Please make all checks payable to AIA Chicago. If you wish to pay by credit card, please fill out the information
       below:

( ) American Express               ( ) Visa                           ( ) MasterCard

Card #                                                                         Expiration Date

Total Amount                       Signature

Payments to AIA Chicago are not deductible as charitable contributions for federal income tax purposes. However, they may
be deductible under other provisions of the Internal Revenue Code.

                                  Please return completed application with payment to:

                                                      AIA Chicago
                                               35 E. Wacker Dr., Suite 250
                                                   Chicago, IL 60601
                                        Tel.: 312-670-7770 ● Fax: 312-670-2422

								
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