GCPCUG Membership Application

Membership Application

Please PRINT THIS FORM, then return this completed form with your :

$35 (General Membership)
$15 (full-time student rate)

check made payable to:
GCPCUG
Attn: Membership
P.O. Box 21509
Cleveland, Ohio 44121-0509

(Returned checks will be assessed a $15 fee)

Check # ______________
Amount Paid:
_________ $35.00
_________ $15.00 (full-time student)
School attending:______________________
_________ Other

Other versions of membership forms:
application.pdf (Acrobat Reader PDF - 125KB)
application.doc (Microsoft Word 2000 document - 67KB)

Full Name:	_______ New _______ Renewal (check one)
Street Address:
City/State/Zip+4: (zip+4 necessary for proper delivery)
Is this a company address? _______YES_______NO NOTE: Check YES if company address is mailing address.
Phone (H):	Email (primary):
Fax:	Email (secondary):
Phone (W):	Company (optional):
Work Extension:	Title/Occupation:
How did you hear of the GCPCUG? (If member referred, print name of member):
If our membership list is used for a non-GCPCUG mailing, do you wish to opt out? _______ YES _______ NO (Check one)
How do you use computers? (Check all that apply) 0 MIS / IT 0 Programmer / Developer 0 Web Designer 0 Consultant 0 Trainer 0 Work Related / End User 0 Home User / Hobbyist 0 Other __________________	We always need volunteers - interested in getting involved? _______ Yes _______ No _______ Not Now _______ Current Volunteer (Check one) If yes, please review the committees below and check all that interest you. We will contact you to find an appropriate committee for you to work with. Feel free to call any Board Member to find out more about a particular committee. 0 PC Chronicles (newsletter) 0 Marketing / Public Relations 0 Web site resource 0 Product Reviews for Newsletter 0 Special Interest Groups (SIGs) 0 Facilities (SIG locations) 0 Membership 0 Member Benefits (Special Offers) 0 Members Assisting Members (MAM) 0 Trade Shows 0 Help at Meetings / Special Events 0 Other __________________

New members: You will receive your first issue of PC Chronicles within 4-6 weeks. Your $35 annual membership fee entitles you to a 12-month subscription to our newsletter, free attendance to all GCPCUG functions, and participation in any members-only raffle. A portion of the membership fee covers costs for the newsletter subscription. (For more information, contact Lori Berenson, Membership Coordinator, at 216-373-7788 or lorib@mail.org.) Thank you for joining!

Thank you to the SIG Leaders, Webmasters, Board Members, and many others that donate their time to make GCPCUG possible!

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