PRiMAL QUICK APP.

Membership Request Form

Do NOT be afraid to add more room.

What are you appling to be (ANSi, Cracking, Agent, etc...)
(You May list more then one.)

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BBS Info...

Current Handle:_________________________________

Previous Handles:________________________________________________
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BBS's Your On:

Name                      Number         Position
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Users You Know:
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Users that you do not wish to know (Enemy's, etc...)

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Current Affiliations:
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Previous Affiliations:
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Experience:

How Long Have you Been Modeming?_________________________________
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How Long Have you Been Pirating?_________________________________
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Can you Crack? _______

If So, How Long? ________________________________________________
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What are Some of Your Latest Cracks (if any)? ___________________
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Do you Hack/Phreak/Card etc. etc. etc.? ______

What specifically? ______________________________________________
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Do you have any experience in ansi art? _______

If so, how much? ________________________________________________
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(Please include some sample work if possible)

Do you have any experience in VGA art? _______

If so, how much? ________________________________________________
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(Please include some sample work if possible)

What program(s) do you most often use to make your art work ?

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Do you have any other skills which may prove useful to tPo? _____
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Personal Information:

How many years have you been BBS'ing? ___________

What Brand and Model Computer are you using (or use most often?)?
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What other hardware do you use? _________________________________
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Software you Use Most often? ____________________________________
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Real Name: ________________________________
Address:   ________________________________
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Age: ______________

Date of Birth: __________________________

Brief Backroung Info? ___________________________________________
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-/-     If you are applying to be a site insert BBS info, Megs, Posts
        perday, Ul's perday, Callers per day, User Ref's, board ref's
        Affils ... etc..

