Silicon Web Costumers Guild (SiW)
Membership Form


_______ Regular Membership for $14.75/year.

Includes membership in Silicon Web Costumers Guild (SiW) and the International Costumers Guild (ICG) plus chapter newsletter.

_______ Household Membership(s) at $6.20 for each additional member at the same address.

_______ Non-Primary Chapter membership for $6.25/year.

$_______ Amount Enclosed

Name ______________________________________________________
Address ______________________________________________________
City ___________________ State ____ Postal Code ____________
Country _____________________________
Phone _________________________________________
E-mail ______________________________________________________
Web Page ______________________________________________________

Send checks or money orders made out to:

Silicon Web Costumers' Guild

and this printed out form to:

Bruce R. MacDermott
2801 Ashby Avenue
Berkeley, CA 94705

Please include your correct mailing address if it is different from your imprinted check address.