ABOIT Membership Form
Member Record Maintenance
The membership list is strictly confidential, and will not be disclosed to
anyone or any agency
outside the ABOIT Membership Committee without your prior notification and consent.
It will only be used for member benefits, verification (if desired), and your membership card.
1629 K Street, NW Suite 300, Washington, DC 20006 202-540-9920 Fax 202-318-2503 info@ABOIT.org
(OFFICE USE ONLY)
Approved _____ Disapproved _____ Date ____________ Reviewed By: ______________