C Z CyberZine Y I -=Application Form=- B

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=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- C Z CyberZine Y I -=Application Form=- B N Part 1 of 1 E E R ! =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- 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____ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 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___ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 3. Are you associated with an organized club or group? If yes explain the name and purpose of the group. yes___ no___ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 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. _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 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...

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