Retired Member or Educator/Student

Please fill in the form below completely and clearly. The following information will be used as your membership listing in the annual directory.

You will be able to update your member information any time using your user name/email and password.

• Member Name

• First Name*
• Last Name*
• Additional Contact Person
• E-mail*
• Username* Usernames cannot be changed.
• Password* Type your password. Minimum length of 8 characters.
• Repeat Password* Type your password again.

• Contact Info

• Phone Number
• Mailing Address
• City
• State
• Zip Code

• About Your Company

• Company Name*
• Website
• Company Description Please describe your products/services in twenty-five words or less. (This information will appear in the web site and the annual directory.)

• Send these credentials via email.