ARIZONA PROGRESS USER GROUP

Application for Membership and Directory Sheet
Membership Type (Check One:)Individual ($25 Annually) Institutional($100 Annually)

Name:______________________________________________________________________________
Home Address:______________________________________________________________________
________________________________________________________ ______ ___________________
                                                         STATE  ZIP

What is your background (experience, education, application,etc.)?________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

Describe Progress configurations and applications you have experience with: ______
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

Other Progress User group Affiliation (if applicable):____________________________

Years of experience:___________

                      List the versions of software that you have experience with:
                      DOS   UNIX   PROGRESS   NOVELL   WINDOWS/NT   OTHER
       Oldest ver.    ____  _____  _________  _______  ___________  _____________
       Newest ver.    ____  _____  _________  _______  ___________  _____________

Phone Numbers (voluntary),  please leave best time to call:
Home Voice: _____________  Office Voice: _____________
  Home Fax: _____________    Office Fax: _____________
     Pager: _____________        Mobile: _____________
Internet:   _____________         Other: _____________

I understand that the information provided
herein is voluntary, and may be published. ______________________________________
                                                        Signature 

OR
Please do not publish(check box if you do not want this information published).

Return to: Arizona Progress User Group
c/o Clark Lathrum
Arizona Corporation Commission
1300  West Washington
Phoenix, Arizona  85007