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Provisional Membership Application - 2020


I hereby affirm that the information contained in this application is true, accurate and complete to the best of my knowledge or belief.  


I understand and acknowledge that if I have knowingly provided any false information or made any knowingly false misrepresentation of the information contained in this Application, my application is subject to rejection.  


I further understand and acknowledge that the IABPA reserves the right to reject any application at its own discretion.

I do affirm*