MEMBERSHIP APPLICATION FOR SENIORNET PAPAKURA INC:

I / WE wish to apply for membership of SeniorNet Papakura Inc, and confirm my eligibility by being 55+ years of age. Enclosed find my cash / cheque for $30 single / $50 double. (Membership renewal on 1st March each year.)

Mr        Mrs        Ms        Dr

First Name/s__________________________________________________________

Preferred First name/s for membership badge/s_________________________

Surname____________________________________________________

Ethnicity_________________Age 50 - 60______60+________

Address_____________________________________________________

____________________________________________________________

Phone_____________________ E-mail_____________________________

Have you previously been a member of SeniorNet Papakura? Yes / No

How did you find out about us?__________________________________

Are you a past or current member of another SeniorNet group? Y / N

If Yes, where / when?_______________ Do you have a computer? Y / N

At our club we use exclusively Windows XP and associated software.

WINDOWS 98 WINDOWS XP WINDOWS VISTA APPLE - MAC

Which programme do you use for WORD PROCESSING? Please indicate the version if known (i.e. Word 2002). Your version is found by opening WORD then selecting from the menu bar HELP then ABOUT.

MS WORKS ______ MS WORD_______ MS WORKS SUITE

MS OFFICE _______ Other_______________________________

SIGNATURE___________________________ DATE_____________________













This page is for your info: and record only.

Please make your cheques payable to SENIORNET PAPAKURA INC: and cross it A/c Payee Only.

Record your Cheque No: here___________________Date Sent________________

Attach your remittance to the FRONT PAGE ONLY and Post this application to:

SeniorNet Papakura Inc

PO BOX 72 427

PAPAKURA

Tel: Gregor Keir (09) 296 8543

or the Learning Centre on (09) 296 7263

for further information.

More information can be obtained by accessing our web site at www.seniornetpapakura.org.nz.

This includes our latest Newsletter and Bulletin Board.