MEMBERSHIP APPLICATION

Pennsylvania Public Purchasing Association

NIGP Chapter #38

Name

Municipality or Governmental Agency

Position/Title

Address

Address 2

City

State

Zip

E-mail

Telephone

Fax

Are you a member of NIGP National?

Yes No

As an Individual or Agency Member

Certifications held:

CPPO CPPB CPM Other

I agree to the payment of current Chapter dues either individually or through my Governmental Agency in accordance with the By-Laws of the Chapter.

Incomplete applications will not be processed.

Name
Municipality or Governmental Agency
Position/Title
Address
Address 2
City
State
Zip
E-mail
Telephone
Fax