Please complete the following form.  The '*' symbol denotes required fields. Information you provide on this form is confidential and will be used only by the user group.  The user group will use this information to better tailor the meetings to the needs of the users and broadest possible audience.

Last Name: *
First Name: *
Title:
Company Name:
Street Address:
City:
State:
Zip:
Office Telephone No.:
Home Telephone No.:
email address: *
Please ensure your email address is correct

 

At what level of technical knowledge would you rate yourself on Cisco products?
Scale of 1 (always call Cisco)  to 
10 (Cisco Network God)

 
Which of the following certifications do you hold if any? 

 
CCDA CCNA CCNP CCDP CCIE
MCP MCSE CNA CNE MCNE
How many locations are in your network?
How many Routers are in your network?
How many Switches are in your network?
How many end users are in your network?
Classify yourself as:

 

End User Reseller Consultant
Would you be interested in volunteering your time to support the administration of the User Group? (i.e. hold office, coordinate meeting schedules, secretary, presentations, etc.)

 

Keep in mind that the user group is supported through 
the volunteer efforts of its individual members.
    If you are unable to submit this form, please email it to OCUG@TekLnk.com

'*' Denotes required information.  All information submitted will be kept private
and will be used solely for notification of individuals interested in participating in
the Omaha Cisco User Group and not be released to any third party.