The Intelec International Mail Network
                    PO Box 212   Baldwin   NY   11510-0212
                    Network Membership Application (#9109)
                    Annual Membership Fee  $12 (U.S Funds)

     BBS Name.............................______________________________

     Your Name............................______________________________

     City, ST, Country....................______________________________

     Public BBS phone (NO Private #'s)....______________________________

     Modem Type/Baud for this number Only.________________ - ___________

     BBS software.........................______________________________

     Operating since (mm/yy)..............______________________________

     Member of other networks (if yes who)______________________________

     Intelec carries 119 conferences, how
     might will you be carrying?..........______________________________

     Level requested (Node, Hub, Reg).....______________________________

     Net software (Qnet, Rnet, Tnet etc)..______________________________

     Requested hub (check nodelist).......______________________________

     Our network nodelist will contain (2)   ___________________________
     *additional* lines x 27 chars for BBS
     info. What would you like in there?..   ___________________________
        (See Our Nodelist For Examples)

     Home/Voice # (Not a day/work number).______________________________

     Mailing Address......................______________________________

     Your date of birth...................______________________________

     Where did you acquire our distribution file?...____________________

     To allow us to view your system,  please give us access under the
     name of CLIFF WATKINS and assign us a password:__________________

     Please DO NOT forget to pre-register this account (if you require
     full information to pre-register this account my date of birth is
     08/19/57, my City/ST is Freeport, NY and voice # is 516 867-4445.

     I have read the  Intelec Network  guidelines  and agree to comply
     with all.  I understand that failure to comply with these and any
     and future Intelec rules and/or guidelines will constitute breach
     of agreement and membership may be terminated with no recourse.

     Name:                                      Date:

      Please make sure this application is completed in it's entirety.
          DO NOT send the $12 Annual Membership Fee  at this time.
               We look forward to your application to Intelec