diff --git a/application/forms/IcingaUserGroupMemberForm.php b/application/forms/IcingaUserGroupMemberForm.php
new file mode 100644
index 00000000..6b474c94
--- /dev/null
+++ b/application/forms/IcingaUserGroupMemberForm.php
@@ -0,0 +1,23 @@
+<?php
+
+namespace Icinga\Module\Director\Forms;
+
+use Icinga\Module\Director\Web\Form\DirectorObjectForm;
+
+class IcingaUserGroupMemberForm extends DirectorObjectForm
+{
+    public function setup()
+    {
+        $this->addElement('select', 'usergroup_id', array(
+            'label' => $this->translate('Usergroup'),
+            'description' => $this->translate('The name of the usergroup')
+        ));
+
+        $this->addElement('select', 'user_id', array(
+            'label' => $this->translate('User'),
+            'description' => $this->translate('The name of the user')
+        ));
+
+        $this->addElement('submit', $this->translate('Store'));
+    }
+}