CFCS Membership Form

Membership
Application

After this application form has been submitted you will have the opportunity to pay online for your membership via PayPal. If you choose not to do this you can print a copy of the completed application and send it with a check to the following address.

About PayPal: To pay with PayPal you will be asked to create an account with them if you do not already have one. It is very simple to do and then you can use your Credit Card to pay for your membership.

Membership Chairman
Central FLorida Computer Society
204 Larkwood Drive Ste 100
Sanford, FL 32771-3643

We're glad to have you join us!

Fields in Red are required

Select the type membership desired:

Individual.....$40.00
Student ......$24.00
Corporate....$132.00

Add Family Member for Name $24.00
I am a registered full time student # at grad.

Section -1: INDIVIDUAL & CORPORATE REPRESENTATIVE INFORMATION

Title:(Mr Mrs etc.) First Name: MI Last Name:

Street Address: City: State: Zip Code:

Alternate address for mail when I call or e-mail "Membership" to activate

Street Address: City: State: Zip Code:

Telephone #: E-mail address:

Occupation: Spouse's Name:

Optional Information:

**...Skill Levels ...**
Computer Interests	Low	Med	High
Word Processing
Spreadsheets
Graphics
Databases
Internet
Web Site Development
Operating Systems

**...Skill Levels ...**
Computer Interests	Low	Med	High
Advanced Technology
Hardware
Networking
Accounting applications
Investing applications
Tax applications
Other:

x	Volunteer Interests
	Meeting setup activities
	Greet guests & members
	Newsletter reporter
	Software/Book review
	Photographer
	Photo Editor
	Perform data entry

x	Volunteer Interests
	Give demonstrations
	Lead a Special Interest Group
	Present programs
	Publicity activities
	Solicit advertising
	HELPLINE resource
	Audit records & processes

x	Volunteer Interests
	Assist in Web maintenance
	Assist in monthly Newsletter preparation/distribution
	Assist in New Update efforts
	Assist in arranging for presentations/programs
	Assist at computer shows

Section -2: CORPORATE MEMBERSHIP INFORMATION

NOTE: The person identified insection 1 above will be the "official corporate representative" who will receive a membership card. A newsletter will be emailed to that address unless you check this block thereby directing the newsletter to be emailed to that person at the corporate address below.

Name: Corporate Phone #:

Street Address: City: State: Zip Code:

Office Name/mail Code/stop POC for advertising:

Your Title: Your Name: Your e-mail address:

I understand that pictures taken at meetings or events which include me, may be published along with my name in the CFCS Monthly Newsletter and on the CFCS web site. Also, that CFCS will not give or sell information submitted on this form to any affiliate, sponsor or other organization.

Application Date: mm/dd/yyyy

Central Florida Computer Society
204 Larkwood Drive, Ste. 100
Sanford, FL 32771

Membership Application

Membership
Application