Participant Record Update Form

If your company, address, email, or other contact information has changed since you last attended an IEEE PCIC conference, we would like to update our records so that you receive timely information about future PCIC events. If you would like to be added to the IEEE PCIC member database, please complete and submit the requested information below. Data fields marked by * are required for new entries to the database.
  • Personal Information

  • Old Contact Information

    To help us better locate your existing record, please provide the following OLD information. If this is a new record, or you don't have the existing information, please skip this section. None of these fields are required.
  • New Contact Information

    The remaining fields will be used to update your PCIC member record. Please provide all required fields and any additional information available.