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

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.
Just fill out this application, sign it, print it and send it along with a check to the Membership Chairperson
Type (check one): New Application Renewal Application
Computer(s) Used: Mac PC
Dues (check one):
per year / per family		 $25.00 per year $20.00 per year
- if over 62 (and not working)
Name:
Address:
City: State: Zip:
Phone: Fax:
E-Mail:
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:
Referring Member: (if applicable)
Optional: How did you hear about BCUG?
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