*Name:

*Title:

*Company:

Address:

City: State: Zip Code:

*Business Telephone:

Cell Phone:

*E-mail:

Total IT Headcount in My Organization:

Do you have a LinkedIn profile? Yes No

*Select Type of membership: Corporate IT Vendor

*Membership Fees:
AIM Utah Chapter - 1 calendar year (January to December) = $250

I have read the AIM Utah Code of Conduct and will voluntarily adhere to its rules*.