GLCUG Application Form

Great Lakes Cisco Users Group - Detroit Chapter

There is a $50.00 membership fee, $40.00 for students with ID (Shirt not included with student rate). Make checks payable to GLCUG. Monthly users meetings are normally held on the last Wednesday of each month. Check the official website for updates at www.glcug.com.
Please submit form with payment to: GLCUG
P.O. Box 99232
Troy, MI 48099-9232

Name: ________________________ ________________________
Last
First
Address: ________________________________________________
Street
__________________ _____ ________________ _______________
City
State
Zip Code
Mail Stop
Phone: _____________________ E-Mail: __________________________________
Company: _______________________________________________
Professional Title: __________________________________________
Golf Shirt Size: S M L XL XXL (circle one)
Why are you interested in joining the GLCUG?
_________________________________________________________
What are your primary areas of interest?
Security
 _____
Wireless
 ______
Voice over IP
 _______
Interoperability _____
QOS
 ______
Certification
 _______
Network Management Tools
_____
 Other: ______________________________
Are you interested in holding any positions in the organization?
_____________________________________________________________________
Where did you hear about us?
_____________________________________________________________________
Club Use Only:
Fee Paid $ ______ Date: ____________ Shirt: _________ Received by: _____________________________