Seattle Community Network (SCN)
User Registration Form

All registered users of the SCN MUST agree to the following Code of Etiquette while using the system:
  1. I will not knowingly engage in illegal distribution practices when posting information. Some examples of illegal distribution are: posting large portions of copyrighted material; posting libelous material; posting material that knowingly aids in a crime; posting credit card number; posting passwords.
  2. I will not attempt to gain unauthorized access to SCN nor use SCN to gain unauthorized access to other systems.
  3. I have read the SCN disclaimer.
  4. I have read and understand the SCN policy statement and agree to abide by it as the governing policy of the SCN.
  5. I will read the description of the forum to which I am posting and post only material relevant to its purpose and theme.
  6. I will not use the SCN to harass individuals or organizations.
  7. I understand that all public material on SCN may be redistributed, subject to copyright laws.
  8. Private e-mail may not be redistributed without permission from the originator of the message.
This version is not an on-line form! From your Web browser, select the "Print" option to print out this page, and fill in the hard copy.

(Please PRINT legibly - except for the signature, of course)

User's Name:__________________________________

Phone:_______________________________

Address:________________________________________

City:_____________________________

State/Prov:_______________________

Zip/Postal Code:_________________

Country:__________________________

Organization or Affiliation:_________________________________

User Signature (required!)__________________________________

Date:_______________

Signature of parent/guardian for minors______________________

Date:_______________

In order to be able to verify your identity over the phone or by email (in case of password problems, etc.), we need a verification code. This will be in the form of a question that you want us to ask you, and the answer. For example, you might have the question be: "What is the name of my dog?", and supply the answer. Then if we need to verify your identity, we will ask you the question, and you supply us the answer. If we don't have this verification information, then we will need to send new passwords or other information to you in the mail.

________________________________________________________________
Verification Question

________________________________________________________________
Verification Answer

If you do not want your real name (as listed above) to appear with your e-mail or contributions to public forums, check here: _____________ (If you make this selection, only your user-id will appear in the header information.)

For a free user-ID, fill out the section above. SCN will automatically assign you a unique identifier (for example, bb001), which you use when you login to the SCN system and to receive electronic messages (e-mail).

If you prefer, we can assign you a customized user identification (user-id). For this, we request a voluntary one-time donation of $25.00. To get your custom ID, fill out the section below. You must include three choices, in order of your preference (some user IDs may be already in use). They will be lower case letters and digits only, up to eight (8) characters each.

1. _____________________________

2. _____________________________

3. _____________________________

In addition, the SCN project always needs additional funds. Please consider making a donation to cover costs, especially much-needed hardware upgrades!

Donations will be published unless you check here _______ to make this donation anonymous.

_______ $25.00 (custom user-id)

_______ $25.00 (Basic)

_______ $50.00 (Family)

_______ $100.00 (Patron)

_______ $500.00 (Corporate)

_______ (other, please specify amount)

_______ Total amount enclosed (make checks payable to SCNA)

Thank you for taking the time to become a registered user of the Seattle Community Network. We will send you your identification, password and login instructions by US Mail. Send completed, SIGNED registration form and optional donation check (made out to SCNA) to:

Seattle Community Network
Post Office Box 15942
Seattle WA, 98115

For questions, send e-mail to: SCN Registration



SCN USE ONLY
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