To print this Application, click on the printer icon on your tool bar, or click on File, then click on Print on the menu bar

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THE COMPUTER CLUB


APPLICATION FOR NEW OR RENEWAL MEMBERSHIP
PLEASE PRINT


NAME(s): ___________________________________________________

ADDRESS (If new): __________________________________________

PHONE (If new): ______________________ DATE: _______________

YOUR CLUB E-MAIL ADDRESS: __________________________________

YOUR CLUB PASSWORD: ________________________________________

SPOUSE CLUB E-MAIL ADDRESS: ________________________________

SPOUSE CLUB PASSWORD: ______________________________________

FEES:
Individual = $10.00
Add Spouse = $5.00

Payment by check would be appreciated.
(Payable to: The Computer Club)

Mail To: Walter Childress, 8645-D SW 94th Lane, Ocala, FL 34481
or bring this Application and payment to any Club Meeting.
Meetings are Tuesday, Thursday and Saturday at 9:00 AM
in the Arbor Conference Center - Suite B and C.

For new members, how did you find out about our Club?

___ OTOW News ___ Friend or Neighbor ___ Other

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