APPLICATION FOR MEMBERSHIP IN PATRIOT NET Name of Sysop (full):__________________________________ Age:__ Occupation:________________________________ Street Address:________________________________________ City, State, ZIP:______________________________________ Name of BBS:___________________________________________ BBS Phone Node1:(___)___-____ Node2:(___)___-____ Voice:(___)___-____ Todays Date:__/__/__ Date you will begin Polling for messages:__/__/__ Place "*" by bases you will carry: _ Firearms (PNFIREAR) _ Christian Patriots (PNCHRIST) _ Washington, DC (PNWAHSDC) _ Militias (PNMILITI) _ Alerts (PNALERTS) _ American Chat (PNAMERIC) * Sysops Echo (PNSYSOPS) Please return as soon as possible to: Kevin Shane (Minuteman) The Patriot's Board BBS (810)693-6012 (819)693-3629 Or via: Compuserve 73732,1033 Prodigy MRSE99A Internet mrse99a@prodigy.com Thanks for applying to Patriot Net. We hope you enjoy being a member.