Membership Information/Inventory Form
To serve you better, we want to know more about you and your system
 
Name: Last _______________________________ First ___________________ Middle initial _____

Address ______________________________________ City ____________________ State _____

 ZIP ________-______ Phone Number: (       ) ______ - ________ EMail:

Please check any of the following items that you may have:
Hardware:

[ ] Computer   [ ] Monitor   [ ] Dot-matrix printer   [ ] Ink-jet Printer (color)   [ ] WebCam
[ ] LASER printer   [ ] Floppy disk drive   [ ] CD-ROM drive   [ ] Speakers   [ ] Digital still camera
[ ] CD-ROM burner   [ ] DVD drive   [ ] DVD burner   [ ] CD burner/DVD-ROM "combo" drive
[ ] Page scanner (slot-feed)   [ ] Flatbed scanner   [ ] Printer/scanner combo unit  

Other hardware:


Software:

Operating System:  [ ] MS Windows, version ______________   [ ] Other:

Office Suite:

[ ] MS Office, version ___________________    [ ] Other office suite (specify):

Individual programs:

[ ] MS Word version ___________________    [ ] Other word processor (specify):

[ ] MS Excel version ___________________    [ ] Graphics program (specify):

Other programs (specify):



Please list your primary areas of interest.  What do you hope to get out of the group?


1) __________________________________________________________________________________________


2) __________________________________________________________________________________________


3) __________________________________________________________________________________________

 

Signature:__________________________________________________                Date: ____ / ____ / _____


If you wish to add further details or comments, you may do so on the back of this form.  Thank you, and welome!