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  1.  
  2.           Association of Shareware Authors and Distributors
  3.              1323 Garfield Avenue, Springfield, OH 45504
  4.  
  5.                       MEMBERSHIP APPLICATION
  6.  
  7.  NAME _____________________ ______________ _________________________
  8.             (FIRST)           (MIDDLE)             (LAST)   
  9.  
  10.  COMPANY ___________________________________________________________
  11.  
  12.  ADDRESS ___________________________________________________________
  13.  
  14.  ADDRESS ___________________________________________________________
  15.  
  16.  CITY __________________________ STATE ______ ZIP __________-_______
  17.  
  18.  PHONE (_____) ___________________   FAX (_____) ___________________
  19.  
  20.  
  21.  PLEASE REGISTER ME AS:
  22.  
  23.      GROUP               FEE  CHECK
  24.      -----------------   ---  -----     Check off each applicable
  25.      AUTHOR/Group        $35  _____     group.  Fee is based only
  26.      AFFILIATED MEMBER   $35  _____     on highest rate.  You will
  27.      BBS                 $45  _____     only be able to cast a
  28.      USER GROUP          $45  _____     vote representing one
  29.      DISTRIBUTOR         $65  _____     group of your choice.
  30.  
  31.  
  32.  ASADnet PRE-REGISTRATION FOR BBS ACCESS:
  33.  
  34.  PASSWORD  _____________________________
  35.  
  36.  DATE OF BIRTH (MM/DD/YY) ____/____/____
  37.  
  38.  COLOR ANSI SCREENS      YES ___  NO ___
  39.  
  40.  AUTHORS .... Please list programs you have written and will mail to
  41.               ASAD.  Programs need to be received as soon as
  42.               possible after membership registration to ensure
  43.               prompt distribution.
  44.  
  45.  _________________________________________________________________
  46.  _________________________________________________________________
  47.  _________________________________________________________________
  48.  _________________________________________________________________
  49.  _________________________________________________________________
  50.  _________________________________________________________________
  51.  _________________________________________________________________
  52.  _________________________________________________________________
  53.  _________________________________________________________________
  54.  _________________________________________________________________
  55.  _________________________________________________________________
  56.  ADDITIONAL INFORMATION:
  57.  
  58.  CompuServe Address _________,_______
  59.  Other Net Addresses _______________________________________________
  60.                     _______________________________________________
  61.                     _______________________________________________
  62.  
  63.  COMMENTS OR SUGGESTIONS:
  64.  _________________________________________________________________
  65.  _________________________________________________________________
  66.  _________________________________________________________________
  67.  _________________________________________________________________
  68.  _________________________________________________________________
  69.  _________________________________________________________________
  70.  _________________________________________________________________
  71.  _________________________________________________________________
  72.  _________________________________________________________________
  73.  _________________________________________________________________
  74.  _________________________________________________________________
  75.  _________________________________________________________________
  76.  _________________________________________________________________
  77.  _________________________________________________________________
  78.  _________________________________________________________________
  79.  _________________________________________________________________
  80.  
  81.  SIGNATURE AND AGREEMENT:
  82.  
  83.  Please register me as a member in the Association of Shareware
  84.  Authors and Distributors.  My check for $____________ is enclosed.
  85.  I understand that I can only vote in one of the above groups of
  86.  representation and I select _____________________________________.
  87.  I understand that as a member of ASAD I must conduct myself in an
  88.  ethical and business like manner when dealing with the public and
  89.  within the shareware community.  I further understand and agree
  90.  that any problems or complaints brought to the attention of the
  91.  ASAD committee regarding my activities will be responsibly
  92.  resolved.
  93.  
  94.  DATE  _____/_____/_____   SIGNATURE _______________________________
  95.                 
  96.  
  97.