Portland Access User Group
Membership Application
A general Membership Listing will be created from the information on this form and distributed to
members of the Portland Access User Group as a Membership Directory. This information is
intended for the non-commercial use of the user group. Any commercial use is
strictly prohibited. The information will be used for the sole purpose of
communicating user group events, or for PAUG related business. If you are
interested in contacting all PAUG members, contact the webmaster. Inclusion in the
Membership Listing and/or the Membership Directory is optional. Should the member choose to
be included in the Membership Listing and not in the published Membership Directory, the
information will remain confidential and will be used for the sole purpose of communicating User
Group events. Upon becoming a member, you can logon to the member’s section at
www.PAUG.com and configure your membership profile.
Non-Discrimination Policy: PAUG does not discriminate based on gender, race, color, national
origin, sexual orientation, religion, disability or age.
By signing below, I agree to the non-discrimination policy as stated above.
Signature*: _____________________________________ Today’s date*: ________________________
I. General Information
Name*: ________________________________________________________________________________________
Company: _______________________________________________________________________________________
Title: ___________________________________________________________________________________________
Bus. Address: ____________________________________ Home Address: ______________________________
City: ___________________________________________ City: ______________________________________
State: __________ Zip: __________________________ State: __________ Zip: ______________________
Phone*: (________) ______________________________ OR Phone*: (________) ______________________
Fax: (________) _________________________________ Fax: (________) _____________________________
email address*: __________________________________ OR email address*: __________________________
*Required. Please complete the remaining fields at www.PAUG.com.
II. Referred by PAUG Member:
III. Annual Membership Dues: $40 for general membership
$50 for consultant membership which includes
notification of job opportunities and a listing on the
consultants’ page available to anyone who visits PAUG’s
website.
All memberships expire on June 1st.
Hand this completed form and dues to one of the User Group officers or mail it to:
Portland Access User Group, Membership, P.O. Box 3654, Portland, OR 97208-3654.
IV. Further Information: PAUG does not have a printed newsletter. Current information is
available on PAUG’s web site at http://www.paug.com/
V. Federal ID: 93-1245764.
Revised 11/15/2006