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Membership
Application
Membership in the Klingon Task Force is open to all persons
without regard to race, religion, sex, economic status, sexual orientation,
gender, disability, national origin, or age.
Step 1:
Complete the following information.
Mr.
Mrs.
Ms. |
Terragnan Name:
First _________________________________
Last _________________________________ |
Mailing Address: ___________________________________________________________
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Apartment or Suite #:__________________________ |
City, Town, or Township:
_____________________________ |
State or
Province:
_______________________ |
Postal Code:
____________________ |
Country:
_________________________________ |
Klingon Name:
__________________________________
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MFI Member Number:
______________________ |
Home Phone:
_______________________ |
Email:
___________________________________________ |
Alternate Email:
_______________________________________ |
Current Age:_________ Birthdate:________________________
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What type of Klingon are you?
________________________________________________________________________________________
OPTIONS INCLUDE:
Imperial Klingon (TNG / DS9 / Voyager)
Half Klingon (TNG / Voyager)[Note other Race in Comments]
Klingon (TOS)
Klingon - Human Fusion (TOS / FASA)
Klingon - Romulan Fusion (TOS / FASA)
Other Blending [Note other Race in Comments]
Comments: ____________________________________________________________________________________________
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Step 2:
Choose A Membership Classification
Active Membership: If you would like to be a full time representative
of the Klingon Task Force, with the Task Force being your only branch of
service.
Reserve Membership: If you wish to serve in other branches beside just the
Klingon Task Force, with the Task Force being a secondary branch of service..
CHOOSE ONE:
Active Membership: ___________
Reserve - Fleet: ___________
Reserve - Marine: ___________
Recerve - Special Forces: ___________
Reserve - Diplomatic Corps: ___________
Step 3: Membership - Individual and Group Information
<TBODY>
<INPUT type=radio value=Mr.1 name=title_before_name>Individual
Member
<INPUT type=radio value=Mrs.1
name=title_before_name>Group Member
<INPUT type=radio value=Ms.1 name=title_before_name>Group
Leader |
Group Info:
Group
Name
<INPUT size=19
name=require:FirstName1>
mIch or
Zone Number <INPUT size=19
name=require:LastName1> |
Group Address:
<INPUT size=40
name=require:StreetAddress1> |
# of Members in Group:<INPUT
name=apt/suite#1 size="20"> |
City, Town, or Township:
<INPUT size=22 name=require:City1> |
State:
<INPUT size=22 name=require:State_or_Province1> |
Country:
<INPUT
size=22 name=require:Country1> |
Group MFI
Member Numbers:
<INPUT size=22 name=Alternate_Email_Address4> |
Group CO Email:
<INPUT
size=22 name=require:Email_Address1> |
Group XO Email:
<INPUT size=22 name=Alternate_Email_Address3> |
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