home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
Floppyshop 2
/
Floppyshop - 2.zip
/
Floppyshop - 2.iso
/
diskmags
/
0022-3.564
/
dmg-3447
/
text
/
memform.txt
< prev
next >
Wrap
Text File
|
1991-07-11
|
2KB
|
34 lines
-----------------------------------------------------------------------------
Atari Computer Enthusiasts (N.S.W.)
G.P.O. BOX 4514 SYDNEY 2001
---------------------------------------------------------------------------
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
____________________________________________________________________________
OFFICE USE ONLY:
Date Processed:____/____/____ Renewal Due:__________ Receipt #:________
M/Card sent:[_]
First Issue #:_____ Last Issue #:_____ Membership #:______ StarterDsks:[_]
______________________________________________________________________________