San Diego Software Industry Council

Membership

NEW MEMBER APPLICATION

To join SDSIC, please fill out the form below and submit it to SDSIC along with your dues payment.

Fields marked with "*" are required

Company Information

*Company:

*Street Address:

Suite:

*City:

*State:

*Zip Code:

*Phone:

*Fax:

*Email:

Web:

*Year Founded:

*#of Employees:

*Company Category:

Main Contact for membership management:(will not appear in directory)

*First Name:

*Last Name:

*Title:

*Email:

*Phone:

Contact names to appear in directory:

*Contact-1 Name:

*Contact-1 Title:

Contact-2 Name:

Contact-2 Title:

Contact-3 Name:

Contact-3 Title:

Company Description to appear in directory:

*Describe your company in 1 paragraph (limit 750 characters, including spaces):

List products or services (450 characters, including spaces):

Payment

Payment for membership dues must accompany the application as either a credit payment (online or faxed) or a check(mailed)

*Select annual dues amount according to membership type

Charge credit card for $

Card Type:

Card Number: - - -

Exp. Date: Required for credit transaction

Name on Card

If you prefer to fax your credit payment, print completed form and fax (858)-793-0655.

Check is being mailed for $
Mail check along with printed application to:
SDSIC
3525 Del Mar Heights Road #339
San Diego, CA 92130

For more information phone (858) 793-6655