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                      Atari Computer Enthusiasts (N.S.W.)
                          G.P.O. BOX 4514 SYDNEY 2001
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                                MEMBERSHIP FORM

    NAME       :_____________________________________________________

    ADDRESS    :_____________________________________________________

    TOWN/SUBURB:____________________________  STATE:____ POST CODE:_____

    PHONES-  Home (_____)______________    Work (_____)_______________

           ATARI COMPUTER MODELS.  (Please mark which models you own.)
                 ST {_}  or  STE {_}  520 / 1040 / 2 MEG / 4 MEG
              SINGLE sided 360K Drive   or  DOUBLE sided 720K Drive

                 SIGNATURE:________________   Date: ___/___/___

            Enclosed is:  [_] Cash    [_] Cheque    [_] Money Order
for:-
          [_] $35 New Membership            [_] $30 Membership Renewal
          [_] $20 Non ACE MEMBER BBS Fee    [_] $10 ACE MEMBER BBS Fee

            Enter BBS Password: ______________  8 Characters Maxium
 Modem setup: 8 Data Bits / 1 Stop Bit / FULL Duplex - 300/1200/2400
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OFFICE USE ONLY:
 Date Processed:____/____/____ Renewal Due:__________ Receipt #:________
                                                              M/Card sent:[_]
 First Issue #:_____  Last Issue #:_____  Membership #:______ StarterDsks:[_]
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