Membership Application
Name:___________________________________________________________________ Company:________________________________________________________________ Mailing Address:________________________________________________________ City / State / Zip:_____________________________________________________ Home Phone:_____________________________________________________________ Work Phone:_____________________________________________________________ Occupation:_____________________________________________________________ Hardware Used:__________________________________________________________ ________________________________________________________________________ Software Used:__________________________________________________________ ________________________________________________________________________ Amount enclosed:$_________________ Today's Date:_________________________
Annual dues are only $24.00. While your membership is active, you will receive The Blinkin Cursor and be entitled to all benefits our group provides.
Please print this form, fill it out, and mail it with your check to:
Milwaukee Area IBM-PC Users Group
4960 N. Wildwood Av.
Whitefish Bay, WI 53217
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