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1995-12-10
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921b
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27 lines
B E T A T E A M A P P L I C A T I O N
Personal Information:
---------------------
Today's Date : _____________________ Date Of Birth : ____/____/____
Full Name <First Mi Last ____________________________________________
Address _____________________________________________________________
City __________________________ State _____ Zip _____________________
Voice Home Telephone Number ( ) ________________________________
Data Number (Home/Other) ( ) ________________________________
BBS NAME ____________________________________________________________
EMAIL Address (Fido or Other, specify) ______________________________
Number of Users on BBS : _____________________________________________
If member of more than one network specify __________________________
How long have you run a BBS? ________________________________________