TPUG - Toronto PET Users Group

TPUG Membership Application Form

Name:             ______________________

Street/PO Box:    ______________________
City/Town:        ______________________
Province/State:   ______________________
Country:          ______________________
Postal/Zip Code:  ______________________

Home Phone:       ______________________
Business Phone:   ______________________
BBS:              ______________________
Email:            ______________________
WWW:              ______________________

Signature:        ______________________

Type of Membership:             __
   Regular Canadian ($10 CDN)  |__|
   Regular USA/Other ($10 US)  |__|

New/Renewal:  __
   New:      |__|
   Renewal:  |__|
   If Renewal, Member Number:  _________

Paid By:          __
   Cheque:       |__|   (Pay to "TPUG".)
   Money Order:  |__|   (Pay to "TPUG".)
   MasterCard:   |__|   (Supply Number.)
   (Sorry, we no longer handle VISA.)
   If Mastercard,
      Card Number:  ____________________
      Card Expiry Date:  _______________

Type of Catalog:

   The first catalog is free.
   GEOS and COMAL catalogs are free.
   Each additional catalog is $1.
    __
   |__|  Amiga (paper+disks)
   |__|  C64 (paper)
   |__|  C64 (disk)
   |__|  C128 (paper)
   |__|  C128 (disk)
   |__|  C128 CP/M (paper)
   |__|  C128 CP/M (disk)
   |__|  GEOS (paper - free)
   |__|  VIC 20 (paper)
   |__|  PET and SuperPET (paper)
   |__|  PET (4040 format disk)
   |__|  PET (8050 format disk)
   |__|  PET and C64 Education (paper)
   |__|  C64/C128 GEOS (paper)
   |__|  C64 COMAL (paper - free)

Please list your equipment and interests:
   Computer:  __________________________
   Memory:    __________________________
   Disk:      __________________________
   Printer:   __________________________
   Modem:     __________________________
   Other:     __________________________
   Interests: __________________________
   Needs:     __________________________

Referred by:  __________________________

Print out, fill in, and mail with payment to:

TPUG
258 Lake Promenade
Toronto, ON Canada M8W 1B3


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