-=*> EmergNet Membership Application <*=- 12/93 (C)1993 Gary Reardon & EmergNet The information in this Application is for internal use only. Please complete as accurately as possible, filling in all information that is applicable to your system and operation. Rename application to your lastname.app & upload or send the application back to us at one of the following locations: FidoNet - 1:321/131 or 2610/14 Internet - f131.n321.z1.fidonet.org BBS - 413-967-8101 or 412-834-1128 FAX - 413-739-9839 SysOp's Name: [___________________] Voice Phone # (___) ___-____ Address : [______________________] City : [____________________] State : [__] Zip Code : [_____-____] County : [________________] Country Code: [___] Latitude : [__-__-__] Longitude : [__-__-__] Elevation : [____] Data can be transposed from known nearby coordinates using the following: 1 Degree = 69.2 mi. = 111 km, 1'= 1.15 mi. = 1.9 km, 1" = 101.5 ft. = 31 m Employers Name: _________________________ Work Phone: (___) ___-____ Ext.[____] Occupation : [___________________] Time @ Work available by phone: ____________ FTN Addresses: FidoNet : AlterNet 7: FmlyNet 8: RbbsNet 8: SurvNet 9: VirNet 9: PernNet 10: OPCN 11: MtlNet 17: ZxXELNET 18: REACTnet 20: MailNet 20: QbbsNet (21-23) 2 : SigNet 2 : IS-Net 40: CandyNet 42: Saf-Net 44: EchoNet 50: CAPNet 55: HobbyNet 57: HealthCare Net 60: CrossNet 73: ICDMnet 77: BbsNet 86: TrekNet 87: IMEX 89: IpecNet 90: EggNet 9 : MagNet 100: SearchNet 114: PoliceNet 150: StormNet 181: MetroNet 200: ZgateNet 225: EzNet 255: MxbbsNet 256: SdaNet 2010: Your Host in all FTN Networks: Zone: [____] Net: [____] Node: [____] Zone: [____] Net: [____] Node: [____] Zone: [____] Net: [____] Node: [____] Zone: [____] Net: [____] Node: [____] Zone: [____] Net: [____] Node: [____] Zone: [____] Net: [____] Node: [____] Are you involved in any of these non-FT Networks? GtNet ___ RelayNet ___ MetroLink ___ MediaNet ___ WWIVNet ___ Other Electronic Mail system Addresses: COMPUSERVE :__________ DELPHI :__________ GENIE :__________ MCIMAIL :________ ATTMAIL :__________ TELEX (___) ___-_____ USENET :____________________________ INTERNET :_____________________________ BITNET :_______________________________ BBS Name: [_________________] Line1# (___) ___-_____ Line2# (___) ___-____ BBS Software: [_____________________________________________] Front End Program: [______________] CM [_] Mail Processor: [___________________] Preferred Mail Compression Format: (Arc, Pak, Lzh, Zip, Arj) [___] Modem Brand:_________________ Model _______________________ Transfer Rate ____ MNP [_] HST [_] V32 [_] V32bis [_] PEP [_] V42 [_] V42bis [_] Pick Passwords : Session Level: [________] Tick/Raid/Areafix: [________] Please list all telephone prefixes that are a local call for you : [___] [___]_________________________________________________________________________ _______________________________________________________________________________ Please describe the computer that will be used for this Network: CPU [_____] Speed [__] RAM [__] Meg Operating System ______________________ Disk Drive(s) ____________________ Hard Drive(s) ____________________________ Monitor Type ________________ Other Accessories _____________________________ =-=-=-=--=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= LapTop/Portable Computer (Describe)____________________________________________ _______________________________________________________________________________ Other Computer Equipment ______________________________________________________ _______________________________________________________________________________ Do you have any of the Following? (Complete all that apply): Generator [y/n] [___]KW Scanner Radio (bands covered & # of chs.) : ___________________________________ IMTS Mobile Phone (#) (___) ___-_____ Cellular Phone (#) (__) ___-_____ Pager (# & type) (___) ___-_________________ Fax Machine (#) (___) ___-_______ Portable Fax [y/n] Graphics Scanner [y/n] Resolution ________________ CB [Y/N] SSB CB [Y/N] HAM [Y/N] (details in last section) Other two way radio equip (type & frequencies): ___________________________ _______________________________________________________________________________ Resources you have access to : ________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Military Service :_____________________________________________________________ _______________________________________________________________________________ Previous experience : _________________________________________________________ _______________________________________________________________________________ Database Program you Use : _______________ can you import a DBASE III file ___ Do you have a Gateway to another Network (describe) ___________________________ _______________________________________________________________________________ If you have a list of local emergency phone numbers & radio frequencies, please attach them to your application, we would like them for our database. ****************************************************************************** Complete this section if you are a licensed Amateur Radio Operator Call Sign [______] License Class [________] Amateur Radio Capabilities (Enter designator(s) that apply for each band) P - Packet V - Voice A - ATV 1.2G _____ 902 _____ 440 _____ 2M _____ 6M _____ 10M _____ 15M _____ 20M_____ 40M _____ 75M _____ 160M _____ VLF _____ Packet Home BBS___________ Routing to you from nearest Network Node__________ TCP/IP [Y/N], 44.___________ ********************************************************************************