*CR* Membership Application

Interested in becoming a member of the Couch Rules Clan? Just fill in the form, click the "Apply now!" button, and we'll reply as soon as possible. Thank you for your interest! You will be hearing from us within a week. If you do not, PLEASE resubmit your application, and blame the foibles of the email systems!

Your Acro name:
Your e-mail address (to be used for clan mailings):

ICQ # :
Other Acro names you use ::
Gender:
Age group (our membership is limited to persons 18 and older):
Current Acro clan or team :
*CR* members who know you and will give you a reference :

Why do you want to be a *CR*?

Any other comments?



Please only hit the Apply now button ONCE! (A separate copy is transmitted every time you hit it! Thanks!)

ZY.Freedback.com: Stunning, fast, FREE! � �
FREE feedback form powered by Freedback.com
Freedback.com


Hosted by www.Geocities.ws

1