MNISPI Membership Application

Please use this form for new memberships or renewals using check payments sent by mail.  Fill out applicable fields, print out the application, and mail it with your payment by check payable to:

Minnesota Chapter ISPI

1730 New Brighton Blvd Ste 104-308

Minneapolis, MN 55413-1661

Questions? - Please contact the membership chair: mrainer@charter.net

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Select Membership Dues That Apply:
   Regular $50
   Group of 5 or more  $40
   Post-Meeting ($15 pre-paid)  $35
   Student Membership  $25
   Consultants' SIG  $10
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Enter Member Information:
The following information is gathered for the membership database and online directory.  Please enter data as you prefer to be represented among colleagues. 

Name (First, MI, Last)

Title

Employer or Organization

Street


City                State               Zip Code
   
Email

Your Web Site

Work Phone (xxx.xxx.xxxx)

Work Fax (xxx.xxx.xxxx)

Home Phone (xxx.xxx.xxxx)

Home Fax (xxx.xxx.xxxx)


Years of Membership in the MN Chapter of ISPI?
Select from the list... 0-2 3-5 6-10 10+  

Work Setting
Select from the list... Independent Consulting/Contracting Training/Performance Improvement Company Academic/Educational Institution Financial Service/Insurance Industrial/Manufacturing Health Services Retail Sales/Marketing Transportation Utility Government Agency (Federal/State/City) Defense/Aerospace/Military

Work Experience/Responsibility
Consultant
Instructional Designer
Learning Specialist
Technical Writer
Designer/Developer
Instructor/Trainer
Teacher/Professor
Education/Performance Technologist
Process/Performance Improvement
Organization Development
e-Learning (CBT/WBT/IMI)
Distance Education & Training
Team Building
Director/Manager
Project Manager
Administrator/Coordinator
Analyst/Assessments/Research
Evaluator
Student
Other

Add You to MN Chapter of ISPI Online Directory? Yes No
Can Your Organization Provide a Meeting Room at No Charge? Yes No
Are you a member of ISPI at the International Level? Yes No
Do You Have the Certified Performance Technologist (CPT) Certification? Yes No

Chapter Involvement Interests
Consultants' Special Interest Group (SIG)
Book Club ("Book Banter")
National Speaker Events
Conferences & Workshops
Professional Development
Career Management
Chapter Programs
Strategic Planning
Membership
Hospitality
Communications/Publicity
Newsletter
Web Site

List Any Unique Professional Skills


List Suggested Topics for Future Programs

List Topics You Are Willing to Present


Sincerest thanks for joining or re-joining The Professional Home for the Performance Improvement Practitioner.  Rewards and benefits are as ample as the opportunities to contribute as a fellow member Dedicated to Improving Human and Organizational Performance.