Brookdale Computer Users Group, Inc

Membership Application

Print this application,  fill it out and send it with check to the Membership Chair

BCUG is a non-profit 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.

  New          Renewal        PC User     Mac User

Dues payable per year per family.  Please Check One:  

    $30.00        $25.00 if 62+ and not working

Name:____________________________________________________________________
Address:__________________________________________________________________
City, State, Zip: _____________________________________________________________
Tel:_________________________________ ______________________________________
Fax: ______________________________________________________________________
E-Mail Address:______________________________________________________________
Recruiting Member If Applicable_____________________________
Optional: How did you learn about Brookdale Computer Users Group?

 __________________________________________________________________

Affirmation:  I/We hereby make application for membership in BCUG, Inc.   I/We certify that the information contained herein is correct. 
Signed: ___________________________________Date:_____________________________

Make checks payable to BCUG and mail to:

BCUG Membership
Paula Greenberg
2 Briscoe Terrace
Hazlet, NJ 07730-1128
Tel: 732-739-2125
Email: prgreenberg@comcast.net