Michiana PC Users Group (MIPCUG)
(Formerly Elkhart PC Users Group)
P.O. Box 13 Elkhart, IN 46515

Membership Application

Please check one of the following:  
Individual membership $20  ___  
Family membership $30  ___

Please provide the following information so that we can bring our database current. *Required items

*Name:
______________________________________________________

*Full address:
______________________________________________________

*Email address:
______________________________________________________

*Telephone #:
______________________________________________________

For family membership please provide the above information for each family member PLUS your relationship to each.

Please make your check out to MIPCUG and mail to
PO Box 13
Elkhart, IN 46515

Benefits to membership can be found at:
http://www.mipcug.org/index.php/membership_ben/