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  1.  
  2.                         CSRNet Node Application Form
  3.                         ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  4.  
  5.  
  6.  
  7.          Your Name: __________________________________________
  8.  
  9.           Your Age: _____    Your Birth Date:  __/__/__
  10.                                                mm dd yy
  11. Voice Phone Number: (   )    -
  12.  
  13.     Street Address: _________________________________
  14.                     _________________________________
  15.                     _________________________________
  16.                     _________________________________
  17.                     _________________________________
  18.  
  19.  
  20.                 BBS Name: ____________________________
  21.  
  22.         BBS Phone Number: (___) ___-____
  23.  
  24.     Current BBS Software: ____________________________
  25.                           ____________________________
  26.  
  27.                  Mailer : ____________________________
  28.  
  29.        Crashmail Support: _____ Yes _____ No
  30.  
  31.              Modem Brand: ____________________________
  32.  
  33.            Max Baud Rate: ____________________________
  34.  
  35.              MNP Support: _____ Yes _____ No
  36.  
  37.       Hours Of Operation: ____________________________
  38.  
  39.  System Has Been Running: _____ Years _____ Months
  40.  
  41.  Approx. Number of Users: ____________________________
  42.  
  43.  Are you applying to be a HUB: ____ Yes ____ No
  44.  
  45.  If No, What is your HUB's CSRNet Address: ___________________
  46.  
  47.  Other Network Addresses: ____________________________
  48.  
  49.               Please complete the entire form and forward to:
  50.  
  51.  
  52.                                 Tim Lajoie
  53.                      c/o The Collosus Soo Resource Net 
  54.                        Data 16.8 USR DS (705)942-5370
  55.                        Voice (9am-9pm)  (705)949-9275
  56.                               CSRNet 11:11/0
  57.                              FidoNet 1:222/21
  58.  
  59.  
  60.                       Please make payments payable to:
  61.  
  62.  
  63.                                  C.S.R.N.
  64.                               c/o Tim Lajoie
  65.                            122 Woodward Avenue
  66.                     Sault Ste. Marie, Ontario, Canada
  67.                                  P6A-3T7
  68.  
  69.