Register
Complete the following form to register.
General Information
Username*:
Screen Name*:
Password*:
 
(Minimum 6 Characters)
Re-enter Password*:
Email*:
Backup Email :
Public Email:
Name*:
Time Zone:
Contact Information
Address 1*:
Address 2:
 
     
Geo Location :
Country:
Phone*:
  Ext. 
Fax:
Cell:
Facebook:
Twitter:
Website:
Company Information
Company*:
Tax Id:
Occupation:
Industry
Category:
Other:
Company Info
Number of Full Time employees*:
Number of Part Time employees:
Business Description*:
County:
Name of referral known to have joined WIBA:
 
Location:
Wichita Boathouse
8/5/2014 11:45 AM to 1:15 PM
Location:
WIBA Board Room
8/6/2014 8:15 AM to 9:00 AM
Location:
Wichita Boathouse
8/12/2014 11:45 AM to 1:15 PM
Location:
WIBA Offices
8/20/2014 11:30 AM to 1:30 PM
Location:
Wichita Boathouse
8/22/2014 11:30 AM to 1:15 PM