Application for beta-site license - PEGASUS/QuickBBS Software
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    #1 - Completely fill out the information to follow. Do not leave
         anything blank. All spaces must be completely filled in or
         the application will not be approved.

    #2 - Sign and Date the form on the proper lines.

    #3 - A notary public MUST sign where indicated.

    #4 - Agreement must be signed and attached with this application.


    Personal Information:
    ---------------------

    Last Name _________________________ First Name and MI _______________

    Address _____________________________________________________________

            _____________________________________________________________

    City __________________________ State _____ Zip _____________________

    Voice Home Telephone Number (      ) ________________________________

    Data Number (Home/Other)    (      ) ________________________________

    EMAIL Address (Fido or Other, specify) ______________________________

    If member of more than one network specify __________________________

    _____________________________________________________________________

    System Configuration ________________________________________________
    (Software/Hardware)
                         ________________________________________________

                         ________________________________________________

    Do you have any special conditions that you feel would make you a
    special consideration in approving this application (Such as uncommon
    hardware/software, etc)?
                            _____________________________________________

    For what reasons do you wish to become a beta test site?

    _____________________________________________________________________

    _____________________________________________________________________

    _____________________________________________________________________

    _____________________________________________________________________




    How long have you run a BBS? ________________________________________

    Are you under the age of 18? If so how old are you? _________________


    The above  information  is  true  to  the  best  of  my  knowledge.  I
    understand  that  any  false  or  misleading information can result in
    immediate revokation of my beta test site license.

    Signed: ____________________________________________   ______________
                                                                Date

    Print your name here: _______________________________________________

    If under 18 a parent or
    guardian must sign here: _____________________________ ______________
                                                                Date




            NOTARY PUBLIC