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                             CyberZine
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                       -=Application Form=-
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                            Part 1 of 1
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Personal Information

1.  Date of Application:

2.  Your Name(First, middle, last):

3.  Your Current Handle:

4.  Other handles you have been known by:



5.  Your Address(address, city, state, zip, country):




6.  Home telephone number:

7.  Home data number:

8.  Age:   

9.  List 3 people that will vouch for you and were they can be   
 reached:
   
     1)

     2)

     3)


Legal information

1.  Are you, or have you ever been a part of or associated with ANY
law enforcement agencies? If yes explain

yes___ no____

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2.  Are you, or have you ever been a part of or associated with any
group that investigates the underground? If yes explain.

yes___ no___

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3.  Are you associated with an organized club or group?  If yes
explain the name and purpose of the group.

yes___ no___

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4.  Are you a reporter?

yes___ no___


Application info

1.  Which are you applying for?

     CyberZine Member Board ________

     CyberZine Dist Site _________

Board info

1.  Board Name:

2.  Number and location of the board:

3.  Current group affiliations to your board:

4.  Number of lines:

5.  CoSysop and Sysop:

6.  Explain why you would like to become either a dist site or   
 member board of CyberZine.

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Send all filled out applications to Stalker in e-mail to:

Inferno
14.4 Sportster
Megs and Megs of warez and h/p
473-0815

or

Stalker
Box 1200
Louisville, KY 40280

Sign(write for you confused people out there)your name in the space
provided if you have truthfully filled out this application.

Name:

Date:

Change the name of this file to include your or your boards name..
ie. Stalker.app...