TAG Membership Application

Basic Information

Institution Name

* Your Name

* Street Address

Address (cont)

* City

* State

* Zip

* Country

* Phone

Fax

* Email Address

Who referred you to TAG? (Name and Company)

Type(s) of ATM you use (check all that apply)

Diebold/InterBold IBM NCR Fujitsu Tidel Triton

Number of proprietary ATMs

No. Branch ATMs

No. Offsite ATMs

Payment Method – Annual Membership Fee US$395

* Choose a payment option

Make your check payable to TAG and mail it to:

The Advisory Group,
P.O. Box 35606
Canton, OH 44735-5606

Membership

Are you a Diebold business partner? Would you like to be a TAG Sponsor? Contact us at info@dieboldtag.com for a sponsor application.