109 Highland Ave
Needham, MA 02494, U.S.A.

Ph:+1-781-444 0404
Fax: +1-781-444 0320
Email: info@omg.org
     

CISQ Sponsor Application

Company Information:

Corporate Information:

 Organization Name:  Name (if different):

 Parent Organization 
 (if any):
  Street Address:

 Primary Business:  City:

 Fiscal Year  State or Province:

 Web Location (URL):  Postal Code:

     Country:
      Application Information Provided By:
  Salutation: Mr. Mrs.Ms.Dr.
  First Name:
  Last Name:
  Title:
  Street :
  City:
  State:
  Postal Code:
  Country:
  Email:
  Phone:
  Fax:
     Designated Representatives:
Please give the name of your Primary Representative who will be responsible for distributing CISQ information within your organization, attending meetings, voting (if applicable) and serving as the communications channel. 
 Check if the same as "Submitter's info"
 
Please provide the name of your Alternate Primary Representative who will also be responsible for distributing CISQ information within your organization, attending meetings, voting (if applicable) and serving as the communications channel.
 
  Salutation: Mr. Mrs.Ms.Dr.
  First Name:
  Last Name:
  Title:
  Street :
  City:
  State:
  Postal Code:
  Country:
  Email:
  Phone:
  Fax:
  Salutation: Mr.Mrs.Ms.Dr.
  First Name:
  Last Name:
  Title:
  Street :
  City:
  State:
  Postal Code:
  Country:
  Email:
  Phone:
  Fax:
   
Please provide a different name of a Marketing Representative who will receive information about how your organization can participate in CISQ's many marketing programs and events. Ideally this will be a member of your marketing department.
 
Please provide the name of your Alternate Marketing Representative who will also receive information about how your organization can participate in CISQ's many marketing programs and events
  Salutation: Mr.Mrs.Ms.Dr.
  First Name:
  Last Name:
  Title:
  Street :
  City:
  State:
  Postal Code:
  Country:
  Email:
  Phone:
  Fax:
  Salutation: Mr.Mrs.Ms.Dr.
  First Name:
  Last Name:
  Title:
  Street :
  City:
  State:
  Postal Code:
  Country:
  Email:
  Phone:
  Fax:
   
Please provide a Billing contact person who can work with CISQ's Finance department for membership fees, payment or other financial issues. (Please note, invoices are mailed to both billing and primary contacts.)
 
Please provide the name of a Public Relations Representative to whom the CISQ can refer editorial opportunities.
  Salutation: Mr.Mrs.Ms.Dr.
  First Name:
  Last Name:
  Title:
  Street :
  City:
  State:
  Postal Code:
  Country:
  Email:
  Phone:
  Fax:
  Salutation: Mr.Mrs.Ms.Dr.
  First Name:
  Last Name:
  Title:
  Street :
  City:
  State:
  Postal Code:
  Country:
  Email:
  Phone:
  Fax:
 
Please provide a name different from the designated representatives to add as Senior Management contact person (CIO,VP of Engineering or Development, etc.) who can be available to discuss, with members of CISQ upper management, important CISQ business-related issues that may affect your organization.
 
(This information is strictly for CISQ use only and will be kept confidential and private.)

 Salutation: Mr.Mrs.Ms.Dr.
 First Name:
 Last Name:
 Title:
 Street :
 City:
 State:
 Postal Code:
 Country:
 Email:
 Phone:
 Fax:

    Sponsorship Level:
     The sponsorship fee is based on level chosen:
Platinum US$55,000
Gold US$40,000
Silver US$25,000
Supporting US$10,000
Government/Academic US$2,500
    How did you hear about us?
Information Kit from us    
News Magazine    
Trade Show    
CISQ Member/Sponsor Company Please Specify:
Other Please Specify:
       

Please let us know the name of an CISQ employee or CISQ international partner, if someone was instrumental in your decision to join CISQ:

   

   

By clicking the 'Submit' button or printing and signing this document below, and mailing or faxing to CISQ, the applicant acknowledges and agrees that, when received and accepted by the CISQ, this application represents a binding contract between the parties and commits the applicant to payment of annual Sponsorship fees. The applicant certifies that it has had the opportunity to review these documents to the extent it desired at the CISQ website, that it meets the conditions of Sponsorship specified in the Bylaws, and that it has accurately stated its revenues in calculating the fees payable with respect to the Sponsorship class which it has selected above. All Sponsorship dues are nonrefundable.

Method Of Payment:

Pre-payment is required to activate membership. Contact the CISQ Membership Office, membership@omg.org,  for assistance, if necessary.

Credit Card - You will be able to continue with the payment on the next page.
  Check

  Make Checks Payable to: Object Management Group, Inc.
 
Mail to: 109 Highland Ave,
Needham, MA. 02494 U.S.A.
 

Wire Transfer- Instructions will be sent to you via Email. Thank you!

Object Management Group
109 Highland Ave
Needham, MA 02494, U.S.A.
Phone: +1-781-444 0404
Fax:+1-781-444-4864
Email:
info@omg.org

 Please, Review All Information Prior To Completing This Transaction!
Please note: Payment is due at the time of registration! This form can not be "saved",
but you can print the filled form for your records.

Please type this code 3TMw8 into the field below, to complete the registration:

 

For more information, please contact The CISQ Membership Office, membership@omg.org, or Accounting Department,
accounting@omg.org, or call OMG at +1-781-444 0404 .  With web/form related issues please contact webmaster@omg.org.