O'Reilly User Group Program: Registration Form

Contact First Name:*
Contact Last Name:*
Position:*
Group Name:*
Shipping Address:*
City:*
State/Province/Region:*
Zip code/Postal code:*
Country:*
Phone:* (for shipping purposes only)
Email Address:*
URL:*
Meeting Date:* (eg. "2nd Tuesday")
Meeting Time:*
Meeting Location:*
Size of membership:*
Average number of members that attend meetings:*
Group Interests/Topics:* (Digital Photography, Video, Graphic Design, Music, Linux, Perl, Oracle, Mac, Windows, Telecom, etc.)
How did you hear about our program?*
Do you have a print newsletter?*	Yes No
Do you have an email mailing list?*	Yes No
Do you have a group library?*	Yes No
Does your Group participate in tradeshows or conferences?*	Yes No
If so, which ones?
Does your Group publish book/software reviews?*	Yes No
Does your Group publish book/software reviews on the web?*	Yes No
Does your Group produce any special events?*	Yes No
If so, what and when?
Do you want to receive a regular newsletter from the UG program with news and info from O'Reilly and other sources?*	Yes No
Do you want O'Reilly catalogs for your members?*	Yes No
If so, how many?
Newsletter Format Preference: HTML or Text

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