Main Line Computer User Membership Form

Name: ___________________________  Date: _____________________________
Address: ________________________  Home Phone: _______________________
City: ___________________________  Work Phone: _______________________
State: ________ Zip: ____________  Email: ____________________________

1. Are you a novice____, intermediate____, or expert____ computer user?

2. Own PC ____, Mac ____, Amiga ____, and/or 64/128____?

3. What other equipment do you have?
   Disk drive(s)/types(s) _____________________ CD-ROM _______________
   Modem/type _________________________________ Other? _______________
   Printer/type ______________________________________________________
   Mouse ______________ Joystick __________Trackball _________________

4. What kind of programs/activities are you interested in? ___________
______________________________________________________________________
______________________________________________________________________

FOR NEW MEMBERS, dues are $15 if you join in Oct -> Mar. $12.50 if you
join in Apr -> June, or $10.00 if you join in Jul -> Sept.

Make check payable to MLCUG and send it to:

     John Deker, Treasurer
     2210 Lantern Ln.
     Lafayette Hill, PA  19444-2211