Indiana
Relocation Council

Membership Application

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* Indicates required field.

Name*
Company Name
Company Address
Company Phone*
Company Fax
Email*
Type of Business
Job Title
Type of Membership (please check one)
Corporate (Corporation that relocates employees.)
Service Provider (Company serving the relocation industry.)
Associate (Not-for-profit organization that may benefit from membership, i.e. Chamber of Commerce)
.
Service providers must list two corporations in the State of Indiana as references.
1. Contact Name
Company Name
Phone Number
2. Contact Name
Company Name
Phone Number
By submitting this form you (name field from above) are electronically signing and dating this form.