Type of Membership (select one):

Single Membership: $30.00

Household Membership: $40.00
 

Name(s):

New or

Renewal
 

Address:

Cash or

Check
 

City: State: Zip:
 

Home Phone: ( ) -
 

Email:
 

Nick Name (first name for your name badge):
 

What are your interests? Check all that apply.
Note: This will not limit SIGs you can join. We just want to get an idea of your interests.

I consider myself:

General Computer Interest

Beginner

Digital Photography Group

Intermediate

Video Makers Group

Advanced

Hardware

Software

Other:
 

Do you have anything else you'd like to share?

Where did you learn about the Thousand Oaks Personal Computer Club?

Store    Newspaper    Person    Other

Name of Store, Newspaper, Person, or Other:
 

Please fill out this form (either online or after printing) and either bring it to a meeting or mail it to TOPCC, 632 Briar Cliff Road, Thousand Oaks, CA 91360. Make checks payable to TOPCC.