AIRA Membership Application

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*First Name: *Company:
Middle Initial *Address 1:
*Last Name: Address 2:
*Email: *City:
*Phone: State:
Fax: *Zip:
Cell: Country:

Current Professional Certifications

CPA Chartered Accountant
Public Accountant CFA
Attorney Other

Current Professional Memberships

Current Organization Year Joined

Membership Category & Dues

$325 Regular
$75 Government Employee/Academic
U.S. trustees, assistant U.S. trustees, analysts, and other professionals working in the U.S. trustee’s office; bankruptcy judges, clerks and other government employees; full-time university/college professors and lecturers; full-time students

Payment Information

*Card Number: *Expiration:
*Billing Zip: *Security Code:

Submit Your Application

By submitting this form, I certify that the information contained within is true and complete to the best of my knowledge, and that I have never been expelled from any professional organization which might have a bearing on this application.