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MEDINET.APP
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The MediNet International Mail Network
C/O One Stop PCBoard
P.O. Box 1130
Richland, WA 99352-1130
Network Membership Application (#9210a)
BBS Name.............................______________________________
Your Name............................______________________________
City, ST, Country....................______________________________
Public BBS phone (NO Private #'s)....______________________________
Home/Voice # (Not a day/work number).______________________________
Mailing Address......................______________________________
Modem Type/Baud for this number Only.________________ - ___________
BBS software.........................______________________________
Operating since (mm/yy)..............______________________________
Member of other networks (if yes who)______________________________
PCRelay (Y/N) ___ FidoNet (Y/N) ___ FidoNet Address _____________
Are you using MCI (friends & family).______________________________
Level requested (Node, Hub, Reg).....______________________________
Net software (Rnet, Tnet, Qnet etc)..______________________________
Mail Door(s) Supported...............______________________________
Requested hub (check nodelist).......______________________________
Your date of birth...................______________________________
If necessary, to allow us to view your system, please give us access
under the name of GARY HEDBERG and assign us a password: MEDINET
Please DO NOT forget to pre-register this account (if you require
full information to pre-register this account my date of birth is
05/04/51, my City/ST is Richland, WA & voice # is 509 946-2301.
I have read the MediNet Network guidelines and agree to comply
with all. I understand that failure to comply with these and any
and future Intelec rules and/or guidelines will constitute breach
of agreement and membership may be terminated with no recourse.
Name: Date:
Please make sure this application is completed in it's entirety.
Thank you, I look forward to your application to MediNet!