ANNUAL MEMBERSHIP APPLICATION
Regular Membership [___] Student Membership [___] Family Membership [___]
(Select only ONE as each member is to complete an application)

Link to application form in WORD or WordPad Rich Text format
Please right click on desired link and "Save Target As".
Complete and/or print the application in MS WORD or WORDPad.
If you do not have MS WORD or WordPad, you can print this webpage or just come to your first meeting.

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Regular or Student Member Name __________________________________________________
(Required for all Applications, even family membership, which requires one person in family to be registered with a Regular membership)

Family Member Name _____________________________________________________________
(Required only for applications from Family members who intend on participating in club activities)

E-mail address ____________________________________________________________________ Special Interest Group (SIG)? PC [_] Vintage [_] Video [_] Imaging [_]
(select sub-groups that you might be interested in)
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(Only Regular or Student members need to complete Address Section as Family member must reside at same address as a Regular member)

Address __________________________________________________________________________

City _________________________________ Prov ______ Postal Code _____ - ______

Telephone ( ___) ________ - __________________ Unlisted? No [__] Yes [__]

Where did you learn about BUG? ___________________________________________________
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COMPUTER INFORMATION: Family members need only complete this section if different from regular member
If you have more than one computer, enter main one here and others on back of form.
Make and model: _________________________________________________________________
Operating system: Windows version: XP [_] ME [_] 98 [_] 95[_] Other _____________________
Home Network: Wired [_] Wireless [_] None [_]
Internet Provider _________________________ HiSpeed [_] Dial-up [_]
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GENERAL COMPUTER KNOWLEDGE: Beginner [_], Intermediate [_], Experienced [_]
Areas of Interest: __________________________________________________________________
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PROGRAMS: Name(s) and version number of the programs that you use frequently.
Word Processor _______________ Spread Sheet _________________ Data Base ____________
Photography / Graphics ______________ Video _______________ Publishing _______________
Other Programs ____________________________________________________________________
___________________________________________________________________________________
This will give us a general idea of the types of things you do with your computer.
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FREEDOM OF INFORMATION:
The Barrie Users Group (BUG) respects your privacy. We protect your personal information and adhere to all legislative requirements with respect to protecting privacy. We do not rent, sell or trade our mailing lists or any of the information above. The information you provide will be used to deliver services and to keep you informed and up to date on the activities of the club.

BUG may
- Record my participation and appearance on video tape, audio tape, film, photograph or any other medium;
- Use my likeness, voice in connection with these recordings;
- Exhibit or distribute such recording in whole or in part without restrictions or limitation for any educational or promotional purpose, which BUG and those acting pursuant to its authority deem appropriate.
The member grants BUG the irrevocable and unrestricted legal and moral rights and permission to copyright these recordings and images and to use them without restriction.

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FOR OFFICE USE ONLY

Date Received ______________________________ Received By ____________________________
Amount of Membership Fee Paid : $_____________
Membership Number : R ________ F________ S ________
Membership Start Date : _____, _______________ 20__
Expiry Date : ______, __________________ 20__
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Bring to Meeting or Mail to
PO BOX 20254, BARRIE, ON, L4M 6H2

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