__New Application   __Renewal __Address Change The MHCUG is a nonprofit educational organization which promotes activities encouraging the use of computers by its members. The MHCUG encourages professionalism and the development of technical skills. A Member may be anyone with an interest in computers who supports the purpose of the MHCUG. A Student Member must be under 25 years of age and attending an educational institution full-time. If new applicant or renewal, please check one: __ Member: dues: $35 per year __ Student: dues: $15 per year Full-time ID (reqr'd) ________________ I am enclosing a check for __1   __2   __3 yrs (Students renew yearly)

Mid-Hudson Computer User Group,Inc. Name:  ____________________________________ Address:  __________________________________                 __________________________________ City State Zip:  ______________________________ Telephone:  (        )   _____________________ E-mail:  _______________________________ How did you hear about us?  __ Friend  __Newspaper/Radio/TV __ Flyer  Other: _________________ If sponsored by a member, please provide name: _________________________________________ Make check (on US bank only) payable to: MH Computer User Group Send form and check to: Attn: Club Treasurer Mid-Hudson Computer User Group PO Box 1962 Poughkeepsie NY 12601-0962

Revised 14 March 2003
Effective April 1, 2003

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