Membership Application

Albuquerque Software Process Improvement Network (ABQSPIN)
2006-2007 Membership Application/Renewal Form

REQUIRED INFORMATION:
Last Name:
First Name:
Preferred Email Address:
OPTIONAL INFORMATION:
Alternate Email Address :
Phone Number :
Extension :
Fax Number :
Street Address :
City :
State :
Zip Code :
Company :
May we share information about you with other SPIN members (Y/N)?
May we share information about you with others outside of SPIN (Y/N)?
PAYMENT INFORMATION:
Amount Submitted:
Cash (Y/N)?
Check (Y/N)?
Check Number :

To become a member of the Albuquerque SPIN, complete this online form or print it out and submit the completed form along with the appropriate funds in the form of either cash or check to:

            Jerry Karasz
            Apogen Technologies, Inc.
            100 Sun Ave NE, Suite 500
          Albuquerque, NM 87109
            Attn: ABQSPIN Membership

Make checks payable to NMITSA (the New Mexico Information Technology & Software Association).

If you have any questions about this form or the status of your membership or membership application, please contact:

            Jerry Karasz
            jerry.karasz@apogentech.com
            505.884.2300 – voice

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