Membership Page

            DEBUG

User Group Survey Membership Application Invoice

  DEBUG Membership #:____________Contact Name:______________________

Company Name:____________________Phone Number:__________________

Company Address:_________________Fax Number :_____________________

  City: ______________________State: _____  Zip Code:  ___________________

Web Address:_________________  E-Mail Address:______________________

Type of Business:_______________   Product Service: ____________________

 Accept Calls? _________________   Member Status: ______________________

# LOCAL USERS
# REM0TE USERS
SYSTEM TYPES
OTHER DEVICES
 
 
 
 
APPLICATION SOFTWARE
SPECIALTY SOFTWARE
PC & NOTEBOOK TYPES
PC APPLICATONS
 
 
 
 
LAN SERVER HARDWARE
LAN OPERATION SYSTEM
LAN TOPOLOGY
LAN APPLICATIONS
 
 
 
 
OTHER AREAS OF EXPERTISE
  

MEMBERSHIP Options

Individual/Consultant________________________________________$40 per year

Corporate/Vendor_________________________________________$75 per year

Guests_________________________________________________$10 per meeting

PLEASE MAKE CHECKS PAYABLE TO:     DEBUG
                                                                        C/O Jack Hale
                                                                        15922 Marshfield Dr.
                                                                         Tampa, FL 33624

Membership Application in PDF format