Registration for January 20 SIRDUG meeting

The price for the meeting is $40. Checks should be made payable to SIRDUG.

The mailing address is: SIRDUG
P.O. BOX 34641
Charlotte, NC 28234

We prefer checks to be hand-carried to the meeting to simplify receiving the checks. If the checks must be mailed make sure that a SIRDUG officer is informed in time to pick up the check from the PO Box.

Please check the box if you wish to attend the June 28th Roger Miller Technical Seminar meeting (The check box is selected by default).
 
June 28:    

This information is required for our meeting registration.
 
First Name:    * - Required
Last Name:    * - Required
E-Mail Address:    * - Required

This information is NOT required from our members, but it can be helpful to us. For instance, we have had times when email for a member was not getting through for some reason. If we have a phone number for the member we are able to contact the member. If we have an alternate email address we can use that if there is a problem with the primary email address. These examples have actually occurred this year.
 
Job Title:   
Phone Number:   
Alternate email address:   
Company:   
Company Address:   
Company City:   
Company State:   
Company Zipcode: