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Home Phone (xxx-xxx-xxxx):

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Employer: Required

Supervisor Name: Required

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Employer Phone (xxx-xxx-xxxx): Required

Employer Fax (xxx-xxx-xxxx):

Are you already an IAAI member?: Required
YesNo

If so, please enter your IAAI membership number:

Occupational Affiliation (select one): Required
Public ServicePrivate InvestigationInsuranceEngineeringScientist or LabLegal

Primary Duty (select one): Required
Fire InvestigatorForensic AccountantScientistManagerInstructorAttorneyForensic EngineerOther

If you selected Forensic Engineer, please specify your discipline:

If you selected Other, please supply details:

Have you ever been convicted of a felony or misdemeanor or any crime, felony or misdemeanor, involving moral turpitude?: Required
YesNo

If yes, please detail offense, date, and location of conviction:

Are you interested in serving on an IAAI committee?: Required
YesNo

Are you interest in delivering IAAI training?: Required
YesNo

Are you a member of another IAAI chapter?: Required
YesNo

If you are a member of another IAAI chapter, which one?:

A recommendation from an existing Indiana chapter member is required. Please provide information about the recommending member below.

Member Name: Required

Member IAAI ID Number: Required

Recommending Member's Phone (xxx-xxx-xxxx): Required

How would you like us to correspond with you? Required
EmailUSPS

If you slected USPS, should we use your personal or employer address?
PersonalEmployer

Any additional message related to your membership application?