Name: Last ___________________ First _________________ M.I.______

Home Address:

__________________________

__________________________

City________________ State ____ Zip __________

Home Phone Number (including area code): ____________________________

Home E-mail: _______________________________

Employer/Business Name: ____________________________

Job Title/Position:_________________________

Business Address:

______________________________________

_______________________________________

_______________________________________

City_________________ State ____ Zip _____________

Business Phone: _____________________________

Business Fax: _____________________________

Business Mobile Phone: _____________________________

Business E-Mail _____________________________

Business Web URL _____________________________

Note: ALL official correspondence from the Oregon GPS User Group will be by ELECTRONIC MAIL unless a member does not have electronic mail readily available and requests correspondence via parcel post by checking the box below.

I prefer to be receive official correspondence from the Oregon GPS Users Group at my

(check one):

___ Home Address;

___ Business Address

___ I DO NOT have electronic mail readily available to me and I request correspondence from the Oregon GPS User Group by parcel post.

Membership Type: (Check One)

___ Corporate Member: I certify by signature below that I utilize GPS in the state of Oregon for the practice of surveying or mapping. $12.00 annual dues.

___ Affiliate Member (Associate): I certify by signature below that I work in direct support of the GPS industry and the profession of surveying and mapping in the state of Oregon. $6.00 annual dues.

___ Affiliate Member (Student): I certify by signature below that I am enrolled as a full-time student in an approved surveying or mapping curriculum. $6.00 annual dues.

___ Affiliate Member (Special): I certify by signature below that I do not meet qualifications for Corporate Member, Associate Member, or Student Member but, by virtue of my employment, service or training, have a particular interest in, or association with, the profession of surveying or mapping utilizing the GPS, and/or, that I am not a resident of Oregon. $6.00 annual dues.

__________________________________ Date _____________________

Signature

Send completed membership application form mail to:

Lisa Lee, Secretary

Oregon GPS User Group

c/o Central Oregon Irrigation District

2598 N Hwy 97

Redmond, OR 97756

2. Enclose a check for dues payable to "Oregon GPS User Group". Dues for Corporate Members are $12.00 annually, and dues for Affiliate Members are $6.00 annually.