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AIA Standards Committee Member Contact Information Update

*We would like to update the contact information for our representatives on the following committee (please check only one. Use separate forms for different committees): GigE Vision®
Camera Link®
Camera Link HS™ Subcommittee
USB3 Vision™
*Company Name:
*Update submitted by (enter first and last name):
*Email:
*Telephone:
*Date:
By submitting this online form, I understand that our committee representatives will be updated/changed by the AIA. I attest that I am authorized by my company to make these changes.
*Electronic Signature:

(Printed name enclosed between forward slashes, i.e. (/John W. Smith/)

Our BILLING CONTACT is: (This contact will be used for billing purposes only, not committee contact)
Name:
Business/Job Title:
Company:
Address:
Address 2 (if needed):
City:
State/Province:
Zip/Postal Code:
Country:
E-Mail:
Telephone:
Our PRIMARY TECHNICAL COMMITTEE REPRESENTATIVE is:
Name:
Business/Job Title:
Company:
Address:
Address 2 (if needed):
City:
State/Province:
Zip/Postal Code:
Country:
E-Mail:
Telephone:
Our ALTERNATE TECHNICAL COMMITTEE REPRESENTATIVE is:
Name:
Business/Job Title:
Company:
Address:
Address 2 (if needed):
City:
State/Province:
Zip/Postal Code:
Country:
E-Mail:
Telephone:
Our ADDITIONAL TECHNICAL COMMITTEE REPRESENTATIVES:
Name:
Business/Job Title:
Company:
Address:
Address 2 (if needed):
City:
State/Province:
Zip/Postal Code:
Country:
Email:
Telephone:

Name:
Business/Job Title:
Company:
Address:
Address 2 (if needed):
City:
State/Province:
Zip/Postal Code:
Country:
Email:
Telephone:

Name:
Business/Job Title:
Email:
Telephone:
Company:
Address:
Address 2 (if needed):
City:
State/Province:
Zip/Postal Code:
Country:
*

I agree that by submitting this form I may receive communications from AIA regarding this and other association activities.

Yes

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