MDT BoF Subscriber WWW Page User Data
Submission Form
E-Mail the information below or print
this PDF form out if you can use PDF
files, otherwise print this page and fill in the blanks, or just
give us the information on a sheet of paper. (Please write or
print legibly.) Send it to the
Webmaster at the address shown
here.
If you are using this page mark out the (yes/no) and (do/don't)
areas below to let us know how to handle your information.
If you have more information than will fit on the form use an additional sheet or two.
Please submit
photos of your truck along with the information requested below.
See Photo Submission for
details on how to send them to us. Note: Please
provide photos to go on your page, based on user feedback
from the www site. We would like a head and shoulders shot
of you, several shots of the truck and one of the truck and
trailer. We will post a page for you with just truck pictures if
you don't want your picture posted.
Fields with an * are optional.
Escapee Number:
_____________________________________________
Member Names, as you want them listed:
____________________________________________________________
BoF members may contact me for more information:
(yes/no write) (yes/no e-mail)
(yes/no phone)
Non BoF members may contact me for more information:
(yes/no write) (yes/no e-mail)
(yes/no phone)
Mailing address: (do/don't put on WWW)
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
E-Mail Address: (do/don't put on WWW)
____________________________________________________________
*Web Site Address: if any (do/don't put on WWW)
____________________________________________________________
* Phone Number: (do/don't
publish on WWW)
* Phone Type: (Home/Cell/Message
Service)
____________________________________________________________
Truck and towing information:
My truck is: (Year, Model, Where purchased, Options, General
description)
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
I have added (accessories)
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
I pull a (trailer length, weight loaded, dingy?)
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
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