Please complete a copy of this form and mail it with payment to: WAC User Group 30 Fendall Avenue Alexandria, Virginia 22304-6300 Contact info: (703) 370-7649 email: membership(at)wacug.org Dues and Membership Options --------------------- $25.00 Dues - Individual/Corporate/Family $5.00 Surcharge - Option for Printed & Mailed Newsletter (2009) $____ Donation Dues are on an annual basis (12 months from payment), and include door prize drawing tickets, and twelve issues of The Cursor newsletter in PDF format with clickable links, sent by email. Payment ------- Please include a check or money order made payable to WACUG, Inc. Privacy Statement ----------------- A membership roster with contact and system information is distributed in June to all members in good standing unless you instruct us to withhold this information. WAC does not provide personal information about its members to commercial interests. However, WAC may release aggregate statistical information that characterizes the overall membership to commercial vendors (e.g., number of members, percentage of members interested in graphics, etc.). Personal Information -------------------- Your legal name, mailing address, and signature is required; all other information is optional. _______________________________________________________________________ First Name Middle Initial Last Name _______________________________________________________________________ Street Address (include apartment number, if applicable) _______________________________________________________________________ City State _______________________________________________________________________ ZIP Code + 4 Country (if not USA) _______________________________________________________________________ Daytime Telephone Number Evening Telephone Number _______________________________________________________________________ Internet Email Address (Required to receive Cursor NL & meeting announcements) __ DO withhold my personal information from other members. ----------------------------------------------------------------------- Signature (required) Date Survey ------ How did you find out about WAC? What specifically can WAC help you with? Special Interests: Please circle areas of interest to you. General Uses: Wordprocessing Databases Spreadsheets Finance Internet/Telecom Education Music Games Other: Advanced Uses: Publishing Animation Video Graphics Sound MIDI Hardware CAD Other: Operating Systems: AmigaDOS Macintosh____ Windows____ MS-DOS OS/2 Linux/Unix CBM GEOS BeOS Other: Programming: BASIC C Java HTML XML HTML Perl Other: I own a VCR or Camcorder (Circle each that applies). Primary Computer System Configuration: Please describe your principle (favorite) system. Manufacturer: _____________________________ Model: ____________________ Processor: _______________________________________ Speed: _________ MHz Disk Drives: __________________________________________________________ Printer(s): ___________________________________________________________ Modem: None 28.8 33.6 56K ISDN DSL Cable FiOS Other Hardware: _______________________________________________________ Secondary Computer System Configuration: Please describe other systems you own. Manufacturer: _____________________________ Model: ____________________ Processor: _______________________________________ Speed: _________ MHz Disk Drives: __________________________________________________________ Printer(s): ___________________________________________________________ Modem: None 28.8 33.6 56K ISDN DSL Cable FiOS Other Hardware: _______________________________________________________ Software (Please list major software packages you own):