Central Ohio DB2 User Group
(CODUG)
2007 Membership Application

Individual and corporate membership application

Name: ____________________________________________________

Company Name: ____________________________________________

Address 1: ___________________

Address 2: ______________________

City: ______________ State: ____ Zip ____

Phone: _____________________

Email address: __________________

For corporate Membership only - give a tentative list of employees that will use this membership:

Name, e-mail, and mailing address (if different from above):

(1)  __________________________ __________________

(2)  __________________________ __________________

(3)  __________________________ __________________

(4)  __________________________ __________________

Individual Membership (qty) _______ at $45 = _________

Corporate Membership (qty) _______ at $135 = _________

Total Amount enclosed: $__________