
          Association of Shareware Authors and Distributors
             1323 Garfield Avenue, Springfield, OH 45504

                      MEMBERSHIP APPLICATION

 NAME _____________________ ______________ _________________________
            (FIRST)           (MIDDLE)             (LAST)   

 COMPANY ___________________________________________________________

 ADDRESS ___________________________________________________________

 ADDRESS ___________________________________________________________

 CITY __________________________ STATE ______ ZIP __________-_______

 PHONE (_____) ___________________   FAX (_____) ___________________


 PLEASE REGISTER ME AS:

     GROUP               FEE  CHECK
     -----------------   ---  -----     Check off each applicable
     AUTHOR/Group        $35  _____     group.  Fee is based only
     AFFILIATED MEMBER   $35  _____     on highest rate.  You will
     BBS                 $45  _____     only be able to cast a
     USER GROUP          $45  _____     vote representing one
     DISTRIBUTOR         $65  _____     group of your choice.


 ASADnet PRE-REGISTRATION FOR BBS ACCESS:

 PASSWORD  _____________________________

 DATE OF BIRTH (MM/DD/YY) ____/____/____

 COLOR ANSI SCREENS      YES ___  NO ___

 AUTHORS .... Please list programs you have written and will mail to
              ASAD.  Programs need to be received as soon as
              possible after membership registration to ensure
              prompt distribution.

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 ADDITIONAL INFORMATION:

 CompuServe Address _________,_______
 Other Net Addresses _______________________________________________
                    _______________________________________________
                    _______________________________________________

 COMMENTS OR SUGGESTIONS:
 _________________________________________________________________
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 SIGNATURE AND AGREEMENT:

 Please register me as a member in the Association of Shareware
 Authors and Distributors.  My check for $____________ is enclosed.
 I understand that I can only vote in one of the above groups of
 representation and I select _____________________________________.
 I understand that as a member of ASAD I must conduct myself in an
 ethical and business like manner when dealing with the public and
 within the shareware community.  I further understand and agree
 that any problems or complaints brought to the attention of the
 ASAD committee regarding my activities will be responsibly
 resolved.

 DATE  _____/_____/_____   SIGNATURE _______________________________
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