PACE : Membership

Personal Information

Please fill out the information below as completely as possible. This information will be used to populate your personal record in the system, which may be updated online in the future. NOTE: The email address you provide will be sent an email to verify your account and give you your password information. Click the OK button at the bottom to proceed to the next step.

You are registering for: Individual

Email:
(required)

Verify Email:
(required)

Salutation:

First Name:
(required)

Middle Name:

Last Name:
(required)

Suffix:

Designation:

Timezone:

Job Title:
(required)

Phone:
(required)

Mobile:

Fax:

Address Line 1:
(required)

Address Line 2:

Address Line 3:

City:
(required)

Country - State/Province:
(required)

Postal Code:
(required)

Personal Website:

LinkedIn Profile:

Twitter ID:

Facebook Profile:

Other Social Media:

Industry:

Areas of Interest:

Other Areas of Interest:

Job Function:

Role:

All Clear

Certifications:

All Clear

Other Certifications:

Preferred Method of Contact:
(required)

Other Methods of Contact:

PACE usually contacts its members via email. To allow us to contact you by other ways, please check the applicable methods below (check all that apply).

Hobbies:

PACE Chapter Interest:

QUICK LINKS

PACE | 8445 Keystone Crossing, Suite 106 | Indianapolis, IN 46240 | 317.816.9336

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