Association of Shareware Authors and Distributors
      2425 North Limestone St., Springfield, OH 45503-1109

                     MEMBERSHIP APPLICATION

NAME _____________________ ______________ _________________________ 
            (FIRST)           (MIDDLE)             (LAST)   

COMPANY ___________________________________________________________

ADDRESS ___________________________________________________________

ADDRESS ___________________________________________________________

CITY __________________________ STATE ______ ZIP __________-_______

PHONE (_____) ___________________   FAX (_____) ___________________


PLEASE REGISTER ME AS:

     GROUP               FEE  CHECK
     -----------------   ---  -----     Check off each applicable
     AUTHOR              $35  _____     group.  Fee is based only
     AFFILIATED MEMBER   $35  _____     on highest rate.  You will
     BBS                 $45  _____     only be able to cast a 
     USER GROUP          $45  _____     vote representing one
     DISTRIBUTOR         $65  _____     group of your choice.


ASADnet PRE-REGISTRATION FOR BBS ACCESS:

PASSWORD  _____________________________

DATE OF BIRTH (MM/DD/YY) ____/____/____

COLOR ANSI SCREENS      YES ___  NO ___

AUTHORS .... Please list programs you have written and will mail to
             ASAD.  Programs need to be received as soon as
             possible after membership registration to ensure
             prompt distribution.

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ADDITIONAL INFORMATION:

CompuServe Address _________,_______
Other Net Addresses _______________________________________________ 
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COMMENTS OR SUGGESTIONS:
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SIGNATURE AND AGREEMENT:

Please register me as a member in the Association of Shareware
Authors and Distributors.  My check for $____________ is enclosed. 
I understand that I can only vote in one of the above groups of
representation and I select _____________________________________.
I understand that as a member of ASAD I must conduct myself in an
ethical and business like manner when dealing with the public and
within the shareware community.  I further understand and agree
that any problems or complaints brought to the attention of the
ASAD committee regarding my activities will be responsibly
resolved.

DATE  _____/_____/_____   SIGNATURE _______________________________