Brookdale Computer Users Group, Inc. (BCUG)
Membership Application

Just fill out this application, print it, sign it and send it along with a check to the Membership Chair
BCUG is a nonprofit corporation organized under the laws of the State of New Jersey principally for educational purposes as specified in Section 501(c)(3) of the IRS Code.
ApplicationType (select one): New Application Renewal Application
Computer(s) Used: Mac PC

Recession Special - New Family Memberships only $15.00, offer valid until 12/31/2013.
Dues per year / per family (please select one):
|   $15.00 - New   |   $30.00 - Renewal   |   $25.00 - Renewal, if over 62 (and not working)   |
Name:
Address:
City: State: Zip: -
Phone: Fax:
E-Mail:
Optional Information
Recruiting Member (if applicable):
How did you hear about BCUG?
Affirmation: I/We hereby make application for membership in BCUG, Inc. I/We certify that the information contained herein is correct and agree to be bound by the rules and regulations of the Group.
Signed:
Date:
Signed:
Date:

Make checks payable to BCUG and mail to:
BCUG/MacWaves Membership
c/o Paula Greenberg
2 Briscoe Terrace
Hazlet, NJ 07730-1128
Phone: 732-739-2125
Email: prgreenberg@comcast.net