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Text File  |  1992-04-02  |  3KB  |  72 lines
  1. Please complete for membership:
  2.  
  3.                    RELAYNET (RIME) APPLICATION FORM
  4.  
  5. ARE YOU APPLYING FOR:    [ ] HUB STATUS           [ ] NODE STATUS
  6.  
  7. SYSOP'S NAME:_________________________________________________________
  8.  
  9. MAILING ADDRESS:______________________________________________________
  10.  
  11. CITY:____________________________  STATE:___________  ZIP:____________
  12.  
  13. VOICE TELEPHONE:______________________________________________________
  14.  
  15. IS THIS PHONE:  [ ] HOME       [ ]  BUSINESS
  16.    (whereever possible please provide a home phone number)
  17. IF A MEMBER OF THE STEERING COMMITTEE NEEDS TO CONTACT YOU VIA A
  18.  
  19. VOICE CALL, WHAT IS BEST TIME TO CALL?________________________________
  20.  
  21. BBS NAME:_____________________________________________________________
  22.  
  23. BBS TELEPHONE:________________________________________________________
  24.  
  25. NUMBER OF NODES:___________  MAXIMUM BAUD RATE:_______________________
  26.  
  27. NUMBER OF YEARS BBS IN OPERATION:_____________________________________
  28.  
  29. BBS SPECIALITY (IF ANY):______________________________________________
  30.  
  31. BBS SOFTWARE:_________________________________________________________
  32.  
  33. NODE ID DESIRED_______________________________________________________
  34.  
  35. HUB ID DESIRED________________________________________________________
  36.  
  37. HUB INTERESTED IN RELAYING WITH_______________________________________
  38.  
  39. SERIAL NUMBER(if software already issued)_____________________________
  40.  
  41. WHERE DID YOU HEAR ABOUT US?__________________________________________
  42.  
  43. HAVE YOU READ A COPY OF THE NETWORK BY-LAWS?       [ ] YES      [ ] NO
  44.  
  45. DO YOU AGREE TO THE ACCEPT THE NETWORK'S BY-LAWS?  [ ] YES      [ ] NO
  46.  
  47.  
  48. SIGNATURE:________________________________________  DATE:_____________
  49.  
  50. Please complete and return this form to:
  51.  
  52.                             Bonnie Anthony, M.D.
  53.                             6901 Whittier Blvd.
  54.                             Bethesda, MD 20817
  55.  
  56.  
  57. FAX Number 301-229-7244
  58. Voice = W:301-229-7028 H: 301-229-7244 BBS:301-229-5623/5342
  59. First year Membership Fee = $25.00
  60. Node Software = $30.00
  61. Hub Software = $60.00
  62. Now accepting Visa/Master Card - fax your form and credit
  63. card number,including your expiration date today, have your
  64. software available for download from my bbs the same day.
  65. Please include a password so I can register you on my BBS.
  66.  
  67. CREDIT CARD #_________________________________________________
  68.  
  69. EXPIRATION DATE_______________________________________________
  70.  
  71. PASSWORD_______________________________________________________
  72.