Colorado Senior Network User’s Group (CoSNUG)

Application for Regular CoSNUG Membership Mail Application (With Dues Payment) to:

Bonnie Snyder, Membership Chair

                                                                                                                                Attn: CoSNUG Membership

            [ ] New Member                            [ ] Renewal                                         62 S. Roosevelt St.

                                                                                                                                Colorado Springs, CO 80910

                                                                                                                                Phone: 719-322-3854

(Please Print)

Last Name: _____________________________         First:*__________________________________________

                                                                                          *Use Name You Want on Name Badge

Address:____________________________________________________________________________________

City:_______________________________________________________ State:______ZipCode:______________

Phone Number:________________________ E-Mail Address _________________________________________

  To qualify for regular membership in CoSNUG, you must be at least fifty-five years of age as of the

date of application. Annual membership dues are $15.00. The CoSNUG General Membership Meetings

are held on the fourth Friday of each month.

                       _________________________________________     ______________________________

                                                Please Sign                                                    Date

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Please help us by completing the following about your personal computer information: (Circle/Fill in)

Brand of Computer:______________________________________ (We do not have classes for MAC Users)

Computer Info:     None   Processor  (AMD / Intel)    Speed  (       M/GHz)   Memory (      M/Gb)

Internet Connection    No    Dialup   DSL    Cable     Wireless    Other

Computer Experience:           0    1    2    3    4    5    6    7    8    9    10        (Circle One)

       None<<<<<<<<<Average>>>>>>>>>>Expert

Committee(s) you would be interested in serving on: (Please Circle One or More)

None               Education                  Funding & Research                        Hospitality                 Library

Membership              Newsletter                  Program                     Publicity

Would You Be Willing To Teach or Assist in Classes? Y ____ N ____

If So, In What area?________________________________________________________________________

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Application Received By:_________________ Date:_________________

Received Check:#_______ Amt.:$_______ Cash: ____ Amt.:$_______