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2. ID#: (Found on Remittance Stub)
4. Member First Name*
5. Member Last Name*
7. Job Title*
8. Work Phone Number*
10. Municipality*
11. State/Province*
12. Country
14. Email Address*
16. City Manager Email
17. Mayor Email
21. Do you need to update any of your membership information?*

    1. No, all of the information on my renewal notice is correct.
    2. Yes, I need to update my information.
23. Which of the following needs updated? If you are moving or have moved to a new municipality, please provide full contact information.

    Check all that apply.

    1. Name
    2. Title
    3. Municipality
    4. Work Address
    5. Work Phone Number
    6. Work Fax
    7. Cell Phone Number
    8. Home Address
    9. Home Phone Number
    10. Email Address
    11. Web Address
    12. Population
25. New Municipality*
27. Municipality You Are Leaving*
29. Did you Replace Someone in your New Municipality?*

    1. Yes
    2. No
31. Please Enter Name of Replaced Employee*
33. Name Change*
35. Title Change*
37. Full Work Address Change*
39. Work Telephone Change*
40. New Work Fax Number*
42. Web Address Change*
44. Home Address Change*
46. Home Telephone Change*
47. New Cell Number*
49. Which email address will you be updating?*

    1. New Work Email
    2. New Home Email
    3. Both Email Addresses
51. New Work Email *
52. New Home Email*
54. Population Change*
58. Annual Membership Fee*
    -- Select One --Full Member: Population up to 20,000 - $185.00Full Member: 20,001 to 200,000 - $225.00Full Member: Over 200,001 - $285.00Additional Full Member - $125.00Associate Member - $125.00Associate Member-In-Transit - $125.00Retired Member - $35.00Outside of North America - $60.00
60. Membership Renewal
    Membership Renewal
61. Taxable
62. Quantity
63. Shipping Cost
65. Annual Membership Late Fee*
    -- Select One --Yes, I will be submitting a late fee. - 15.00NO, I will not be submitting a late fee. - 0
67. Quantity
68. Shipping Cost
69. Taxable
71. IIMC Foundation Education Contribution*
    -- Select One --Yes, I would like to donate. - $25.00No, thank you. - $0.00
73. Continuing Education
    Continuing Education
74. Quantity
75. Shipping Cost
76. Taxable
Leave This Blank:


77. Calculate Totals Proceed to Checkout

* indicates a required field