Individual Membership Application

Your name*

First

Last

Work Title*

Email Address*

The address where you wish to receive TAtech newsletters & announcements; please add peterweddle@TAtech.org to your safe list so you receive these communications.

ORGANIZATION INFORMATION

Company

Name	Website address

Business Address

Street Address

City

State / Province / Region

ZIP / Postal Code

Country

Telephone number*

Your Role

Select NO MORE THAN TWO of the following categories to describe your role:

Other (please specify):

Years of experience in HR/TA:

1-5
6-10
11+