NoCOUG Individual Membership Application
Personal Information (* Required fields)    
  First Name*   Last Name*
Job Title
Job Role
   
    Mailstop Phone Number
   
  Address   City
State
Zip
  
     
  Email Address* Confirm Email Address*  
   
       
Mailing Lists    
  Would you like to receive notifications of upcoming NoCOUG conferences? Yes No
  Would you like to receive other announcements from NoCOUG? Yes No
  Would you like to receive mail from third parties? Yes No
  Would you like to receive email from third parties? Yes No
       
Presentations    
  Might you be interested in giving a presentation at a future NoCOUG conference? Yes No
Journal    
  Delivery Preference? Online (Download PDF) Paper (US Mail)

Payments will be processed by PayPal.
Have your credit card ready, you will be asked to provide it after you confirm your registration.
Membership Dues        
  Membership Type Includes Rate    
  Individual Membership Quarterly Journal and Meeting Attendance for 2011 $95.00  
           
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