Charter Membership Application Request: Please fill out the information below. Once   done, click on the submit button below.
Memer Information
First Name		Last Name
Company Name
Street Address
City
State/Province		ZIP/Postal Code
Country
Phone		Fax
Email
WISE Membership Information
WISE Number		Member Level	CEO CORPORATE COMPANY GENERAL INDIVIDUAL DISSEMINATOR
Activation Date   (mm/dd/yyyy)		Member Since? (mm/dd/yyyy)
Proposed User Name and Password
USER NAME: This is different than your password and is NOT changeable. Example: WUSSAC01 (WUS SACRAMENTO 01) or AFJBGJOEB (AF JOHANNESBURG JOE BLOW). It is not important to be keep confidential and should be easy to remember.
PASSWORD: This is confidential and must be kept secure. You can change this after you log in, under the "Administration" section.
User Name		Password
Questioinaire
Please describe briefly what you would like to achieve as a Charter member of WISE:
Please describe briefly what you would hope to gain as a Charter member of WISE:
What prompted you to apply for Charter membership?