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1993-11-27
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-=*> EmergNet Membership Application <*=- 12/93
(C)1993 Gary Reardon & EmergNet
The information in this Application is for internal use only.
Please complete as accurately as possible, filling in all
information that is applicable to your system and operation.
Rename application to your lastname.app & upload or send
the application back to us at one of the following locations:
FidoNet - 1:321/131 or 2610/14
Internet - f131.n321.z1.fidonet.org
BBS - 413-967-8101 or 412-834-1128
FAX - 413-739-9839
SysOp's Name: [___________________] Voice Phone # (___) ___-____
Address : [______________________] City : [____________________] State : [__]
Zip Code : [_____-____] County : [________________] Country Code: [___]
Latitude : [__-__-__] Longitude : [__-__-__] Elevation : [____]
Data can be transposed from known nearby coordinates using the following:
1 Degree = 69.2 mi. = 111 km, 1'= 1.15 mi. = 1.9 km, 1" = 101.5 ft. = 31 m
Employers Name: _________________________ Work Phone: (___) ___-____ Ext.[____]
Occupation : [___________________] Time @ Work available by phone: ____________
FTN Addresses:
FidoNet : AlterNet 7:
FmlyNet 8: RbbsNet 8:
SurvNet 9: VirNet 9:
PernNet 10: OPCN 11:
MtlNet 17: ZxXELNET 18:
REACTnet 20: MailNet 20:
QbbsNet (21-23) 2 : SigNet 2 :
IS-Net 40: CandyNet 42:
Saf-Net 44: EchoNet 50:
CAPNet 55: HobbyNet 57:
HealthCare Net 60: CrossNet 73:
ICDMnet 77: BbsNet 86:
TrekNet 87: IMEX 89:
IpecNet 90: EggNet 9 :
MagNet 100: SearchNet 114:
PoliceNet 150: StormNet 181:
MetroNet 200: ZgateNet 225:
EzNet 255: MxbbsNet 256:
SdaNet 2010:
Your Host in all FTN Networks:
Zone: [____] Net: [____] Node: [____] Zone: [____] Net: [____] Node: [____]
Zone: [____] Net: [____] Node: [____] Zone: [____] Net: [____] Node: [____]
Zone: [____] Net: [____] Node: [____] Zone: [____] Net: [____] Node: [____]
Are you involved in any of these non-FT Networks?
GtNet ___ RelayNet ___ MetroLink ___ MediaNet ___ WWIVNet ___
Other Electronic Mail system Addresses:
COMPUSERVE :__________ DELPHI :__________ GENIE :__________ MCIMAIL :________
ATTMAIL :__________ TELEX (___) ___-_____ USENET :____________________________
INTERNET :_____________________________ BITNET :_______________________________
BBS Name: [_________________] Line1# (___) ___-_____ Line2# (___) ___-____
BBS Software: [_____________________________________________]
Front End Program: [______________] CM [_]
Mail Processor: [___________________]
Preferred Mail Compression Format: (Arc, Pak, Lzh, Zip, Arj) [___]
Modem Brand:_________________ Model _______________________ Transfer Rate ____
MNP [_] HST [_] V32 [_] V32bis [_] PEP [_] V42 [_] V42bis [_]
Pick Passwords :
Session Level: [________] Tick/Raid/Areafix: [________]
Please list all telephone prefixes that are a local call for you :
[___] [___]_________________________________________________________________________
_______________________________________________________________________________
Please describe the computer that will be used for this Network:
CPU [_____] Speed [__] RAM [__] Meg Operating System ______________________
Disk Drive(s) ____________________ Hard Drive(s) ____________________________
Monitor Type ________________ Other Accessories _____________________________
=-=-=-=--=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
LapTop/Portable Computer (Describe)____________________________________________
_______________________________________________________________________________
Other Computer Equipment ______________________________________________________
_______________________________________________________________________________
Do you have any of the Following? (Complete all that apply):
Generator [y/n] [___]KW
Scanner Radio (bands covered & # of chs.) : ___________________________________
IMTS Mobile Phone (#) (___) ___-_____ Cellular Phone (#) (__) ___-_____
Pager (# & type) (___) ___-_________________ Fax Machine (#) (___) ___-_______
Portable Fax [y/n] Graphics Scanner [y/n] Resolution ________________
CB [Y/N] SSB CB [Y/N] HAM [Y/N] (details in last section)
Other two way radio equip (type & frequencies): ___________________________
_______________________________________________________________________________
Resources you have access to : ________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Military Service :_____________________________________________________________
_______________________________________________________________________________
Previous experience : _________________________________________________________
_______________________________________________________________________________
Database Program you Use : _______________ can you import a DBASE III file ___
Do you have a Gateway to another Network (describe) ___________________________
_______________________________________________________________________________
If you have a list of local emergency phone numbers & radio frequencies, please
attach them to your application, we would like them for our database.
******************************************************************************
Complete this section if you are a licensed Amateur Radio Operator
Call Sign [______] License Class [________]
Amateur Radio Capabilities
(Enter designator(s) that apply for each band) P - Packet V - Voice A - ATV
1.2G _____ 902 _____ 440 _____ 2M _____ 6M _____ 10M _____ 15M _____
20M_____ 40M _____ 75M _____ 160M _____ VLF _____
Packet Home BBS___________ Routing to you from nearest Network Node__________
TCP/IP [Y/N], 44.___________
********************************************************************************