Registration for SIRDUG membership

The first group of information is required for our members. We do not share this information with any vendors and it is only used for the administration of user group activities.

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 Address:   
Company City:   
Company State:   
Company Zipcode: