Join SEC

Section A:  Contact Information

Organization:

Type of organization:

Salutation: none Mrs. Ms. Mr. Dr.

Primary Contact First Name :

Primary Contact Last Name:

Title:

Department (if applicable):

Primary Function: Purchasing Information Technology Property Management General Administration Environment Other

Address 1:

Address 2:

City:

State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Zip:

Phone:

Fax:

Email:

Website:

Section B:  State Electronics Challenge Pledge

Our organization pledges to participate in the State Electronics Challenge (SEC) as a Partner and understand that we can apply to receive recognition at the Bronze, Silver, or Gold level.  We recognize that the ultimate goal of the SEC is to improve the environment through the management of electronic assets throughout the lifecycle, including purchasing, operations and maintenance, and end-of-life management.

Which life-cycle phases is your organization interested in addressing?

Purchasing

Operations & Maintenance

End-of-Life Management

Don't Know

What recognition level are you interested in applying for?

Total number of employees in your organization:

Section C: How Did You Hear About the SEC?

Within four weeks of submitting this registration form, please complete the
Baseline & Annual Reporting Form.

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