_____ _____ _________ ___________ _______ ______ ____ ___ -- --- _ --- ____ __ -- __ __ _____ - ______ ______ ____ ______ __________ ________ __ ____ the 5th membership application form _______________ ------ ---- 1st name lastname handel shortcut address em telephone number (+ ) age (please notice that you must be under 1o3 years old thank you) abilities ansi isna ascii iicsa rip pir vga agv lit til other rehto if other please put your notes here