Application to Join NiUG as a Company Member

Basic Info

Organization Name    
First Name    
Last Name    
Email    

Please tell us how you heard about NiUG:

Heard About
Referred By    
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Additional Info

Number of iMIS Licenses
Title    
iMIS Edition
Address 1    
Address 2    
City    
State/Province    
Zip/Postal code    
Country    
Telephone    
Fax    
Website    
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Submit

Upon submitting your application it will be reviewed by a NiUG staff member.

We will contact you in regard to next steps.

Thanks,
NiUG
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