Sponsorship Form

Sponsorship Form

Remember Sponsors Needed for the New Web Site www.ccciapmo.org

Look us up ... Put your name on the List Of Chapter Sponsors

Help us grow, and keep up to date on the latest Code Developments

*Name:*
*Address:*
*City:*
*State:*
*Zip Code:*
*Phone:*	*Ext.*
*Fax:*
*Company:*
*Job Title:*
*Amount:*
*Email:*
	*Yes, I would like to receive notices via Email from CCCIampo.*

Recommended amount for Yearly Dues = $20.00

Recommended amount for Web Sponsorship = $100.00

Make checks payable to: "CCC IAPMO"
Send to:	Bob Adler
	Information Inspector,City of San Jose
	801 North 1st Street - Room 200
	San Jose, CA 95110-1795

Thank you for your Support!