Application/Renewal for ICOWF Membership
Complete the application below. Click the PRINT button to print completed application. Iowa Council on Welfare Fraud To make changes to current memberships, simply print and mail. No additional money is needed. * = required field Type of Application (Place an "X" in the appropriate block below) Mail application and check to: ____________, Iowa ____________
Send application along with a $25.00 check or money order for new memberships or renewals to:
PO Box _____
_______________, Iowa ______
*Your Name:
Title:
Organization:
*Address 1:
Address 2:
*City:
*State:
*Zipcode:
*Email Address:
*Phone Number:
(
)
ext.
New Membership:
Renew Membership:
Change Report:
Referred by:
Iowa Council on Welfare Fraud
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