Membership Renewal Form -

Renew your group’s membership by December 31 to be entered into the random drawing contest. Annual dues are $50.00 and delinquent on January 1. If payment is not received by January 31, your group will be marked Inactive in the membership database.

Fields marked with an * are required. The more optional data you complete, the better APCUG can ensure your group receives information about its benefits, contests, up-to-date news, etc.

Payment, printing, and submittal information is below the form.

NOTE: Don’t forget to print this form. Clicking Submit is the last step.

If you have any questions or need help, click here to contact the Membership Committee.

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

User Group Name *

Acronym *

Your Contact Information:

Name of person completing the form *

Position and title *

Email address *

Phone Number *

Paying via PayPal or check *

PayPal
Check

Group's Web Site https:// *

Social Media URL's

Facebook

Twitter

YouTube

Meetup

President's Name *

President's Email address *

Treasurer’s Name *

Treasurer’s Email address *

APCUG Rep

APCUG Rep's Email address

Location / Place of Your Meeting * Help Text

Group's Meeting Street Address *

Meeting City/State/Zip *

Country *

Group's Mailing Street Address *

Mailing Address City/State/Zip *

Group's Country *

Group Email address *

Group Phone Number

Election Month *

Number of Members *

Meeting Day * Help Text

The more contacts you provide for the UGLS (membership database), the easier it is for your group to receive information about benefits, contests, and up-to-date news.

Editor's Name

Editor's Email address

Webmaster

Webmaster's Email address

Vice President’s Name

Vice President’s Email address

Secretary’s Name

Secretary’s Email address

Program Chair

Program Chair’s Email address

Membership Chair

Membership Chair’s Email address

WHERE DOES THE FORM GO WHEN YOU CLICK SUBMIT?
The completed form is sent to the Membership Committee. You will receive an acknowledgment when the form has been received. If you do not receive one, please send an email to the Membership Committee.

Click HERE to print the form before clicking on SUBMIT!

PAYING BY CHECK

Please put your group's name on the Memo line and include the first page of this form with the $50.00 check; mail both to:

APCUG
PO Box 1384
Pine AZ 85544-1384

PAYING BY PAYPAL

If you are paying by PayPal, click the submit button to open the PayPal form page.

Thank you for being a member of APCUG.