Note: Membership dues can also be paid at the monthly meeting on the second Thursday of the month at Ivy Tech campus.

Instructions: Print this page and cut along the dashed lines.

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Kokomo PC Users Group
Membership
Application Form

To join the Kokomo PC Users Group please print in the blanks below.

Date: _______________________________________

Name: ______________________________________

Address: ____________________________________

City and State and Zip Code: ___________________________________

Phone Number: ______________________________________________

E-Mail address (Optional): _____________________________________

Enclose $10.00 check for annual membership dues.
Send Application and $10.00 dues check to:

Rodney Malkoff (Membership Services)

3209 Janice Drive

Kokomo, Indiana 46902-3923
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