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First Name*
Last Name*
Email*
Court/Organization Name*
Address 1
Address 2
City
State
Zip
Country
Day Phone
Jurisdiction Type
<---- Select One ---->Trial CourtIntermediate Appellate CourtCourt of Last Resort
Jurisdiction Size
<---- Select One ---->Large (1 million residents or more)Small (less than 1 million residents)
IT Experience
<---- Select One ---->1-5 years6-10 yearsMore
Court Experience
<---- Select One ---->1-5 years6-10 yearsMore
Experience Leading Court IT
<---- Select One ---->1-5 years6-10 yearsMore
ITIL Certification (check if yes)
PMP Certification (check if yes)
Microsoft Certifications - e.g., MCSE, MCSA, etc. (check if yes)
Cisco Certifications (check if yes)
ICM Certifications (check if yes)
Other Certifications (please list)
Position Title
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