Bufbotics: Membership Application

Membership Application

Identification:
Name	*
Email	*
Your Email address will be kept private. It will only be used to contact you regarding Bufbotics club-related matters.
Type of Membership:
Choose One	*	Full Explorer Guest
Click for Help Choosing. If you are under 18 years of age, you must choose "Explorer".
Contact Information:
Phone
Street
City	*
State/Province	*	- OR -
Zip/Postal Code
Experience Levels:
Electronics		Novice Intermediate Expert
Software Programming		Novice Intermediate Expert
Robot Construction		Novice Intermediate Expert
How did you find Bufbotics?
Internet Search
Link from other Robot Club
Flyer
Referred by a Friend
Other
Other Information:
Other Hobbies/Interests