ACGNJ MEMBERSHIP APPLICATION
Amateur Computer Group of New Jersey
PO Box 319
South Bound Brook, NJ 08880
Û Ý Ne÷ Membeò Dueó arå ¤14.00
[ ] Renewal Foreign air mail 27.00
[ ] Address change
Please make checks payable to ACG-NJ
First name:__________________ Last name: _______________________
Mailing Address: ________________________________________________
City: ___________________ State: _____ Zip: ______ Country: _____
Business phone: (___) ___-____ Home phone: (___)___-____
[ ] Do not list me in the Membership Directory
[ ] Electronic Engineer [ ] Chemical Engineer [ ] Programmer
[ ] Student [ ] Electronic Tech [ ] DP Manager
[ ] Systems Analyst [ ] Consultant [ ] Teacher
[ ] Other, specify ____________________________________________
Who is your employer:__________________________________________
PART II:
What topics would you like covered at club meetings:
Would you like to speak at a club meeting? [ ] yes [ ] no
Topic(s):
Can you help the club? [ ] general [ ] newsletter [ ] festival
[ ] meetings [ ] user group
What can you do?
PART III
Central Processing Unit
8088 Z80/8080 6800/09 6502 Misc
[ ] IBM-PC [ ] TRS-80___ [ ] SWTP 6800 [ ] Apple_____ [ ] 1802 ____
Û Ý IBM-XÔ Û Ý TDL/Xitaî Û Ý SWTÐ 680¹ Û Ý Kim-± Û Ý TÉ-9900
[ ] IBM-JR [ ] HB [ ] TRS-80 Color [ ] Comm _____ [ ] 8085
[ ] Compaq [ ] IMSAI___ [ ] HB [ ] HB [ ] 68000
[ ] Columbia [ ] North Star [ ] Mot EK [ ] Atari __ [ ] Z8000
[ ] Seequa [ ] Altair [ ] Heath [ ] AIM [ ] DEC _____
[ ] other* [ ] other* [ ] other* [ ] other* [ ] other*
*Specify:____________________________________________________________________
Peripherals
Printer CRT Term Disk Misc
[ ] TTY Mod:________ [ ] ADM _______ 5" 8" [ ] Modem
Š[ ] Selectric [ ] Hazel _____ [ ] [ ] Tarbell [ ] Music Syn
[ ] Diablo [ ] SWTP [ ] [ ] North * [ ] DAC
[ ] TI Mod:_________ [ ] Heath [ ] [ ] TRS-80 [ ] ADC
[ ] Dec Mod:________ [ ] Soroc [ ] [ ] Apple [ ] Prom Burner
[ ] Centronix Mod:__ [ ] HB [ ] [ ] SWTP [ ] Voice out
[ ] Heath [ ] Televideo [ ] [ ] Micropolis [ ] Voice in
[ ] IDS Mod:_____ [ ] other [ ] [ ] SD sales [ ] Dazzler
[ ] Epson Mod:_____ [ ] [ ] other [ ] other
[ ] TRS Mod: _____ -------------
[ ] Okidata Mod:___ ------------------- ______________
[ ] other
[ ] Hard disk __________________
--------------------
DOS: ___________________________
Cassette type: ______________________________ Ram Size: ____________________
Video Board (specify) _______________________ Other Equip: _________________
___________________ What do you plan to buy? ________________________________
Applications:
[ ] Software development [ ] Hardware development
[ ] Word processing [ ] Process control
[ ] Education [ ] Business
[ ] Hobby [ ] Graphics
[ ] Ham radio [ ] Music
[ ] Games [ ] Scientific
[ ] other:
Comments: