LDW WEBMASTER GUILD
Membership Application

Applicant Information

Name:

Date of Birth:

Nickname:

Phone:

Address:

City/State:

Nationality:

Marital Status:

Children:

Sex:

Email:

Best Personality Trait:

Hobby:

School:

Known For:

Design Talents

Do You Design? (Answer Each with YES/NO)

Sites:

Banners:

Graphics:

Themes:

FAVORITES

Animal:

Color:

Dessert:

Sport:

Sports Team:

Music:

Fun Information

Epitaph:

Favorite Pizza Topping:

Apples/Oranges/Neither:

Signature

I affirm that the information listed above is accurate and true.  I agree to have the guild verify any and all information.

Electronic Signature:

Today's Date: