Atari Computer Enthusiasts (N.S.W.) 
             G.P.O. Box 4514,  SYDNEY 2001  Fax Phone: 6658416
                            MEMBERSHIP  FORM 
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    NAME       :_____________________________________________________

    ADDRESS    :_____________________________________________________

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

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

 Enclosed is:  [ ] Cash    [ ] Cheque         [ ] Money Order
               [_] VISA    [_] MasterCard     [_] BankCard
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  Credit                                          Credit Card
Card Number: [________]-[________]-[________]-[________]  Expiry Date: ___/___
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       For:- [_] $35 ACE(NSW) New Membership   [_] $30 ACE(NSW) Renewal
             [_] $20 BBS Fee Only              [_] $10 ACE MEMBER BBS Fee

                 SIGNATURE:________________   Date: ___/___/___

     Please mark which ATARI model you own  and  Memory size.

      STFM [_]   or   STE [_]   or   TT [_]       Memory Size: ___________

         SINGLE sided [_] 360K Drive   or  DOUBLE sided [_] 720K Drive
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OFFICE USE ONLY:
 Date Processed:____/____/____ Renewal Due:__________ Receipt #:________
                                                               M/Card sent:[ ]
 First Issue #:......  Last Issue #:......  MemberID #:......  StarterDsks:[ ]
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