Sailor Moon Palace - Membership Application

I'm a member of

This is the application for membership in The Palace Society. Be sure to fill it out completely and accurately. The Character Information is who you want to be portrayed as in the Society. It doesn't neccessarily have to match your character representation image. Once you submit your application, be sure to select a logo and place it in an easy-to-find area. Also send your character representation to me.

Character Information (visible to everyone)

Name (ex: Tuxedo TwO):

E-Mail Address (ex: name@aol.com):

Location (ex: Crystal Tokyo):

Character B'day (ex: April 4, 2014):

Character's Special Powers:

Character Interests:

Website Title:

Website URL:

Briefly Describe Your Site

Real Information (only I see it)

Real Name (ex: Chris Fannin):

Real B'day (ex: August 15, 1979):

Sex (Male or Female):

Real Address:

Address, Line #2:

City, State, ZIP:

Check off all your interests. They will determine what type of prize you get if you win.

Books: Fiction	Computers: Graphic Arts	Music: Country	Comics
Books: Non-Fiction	Computers: Word Processing	Music: R&B/Rap	Console Gaming
Books: Horror	Computers: Web Design	Music: Rock	Concerts
Books: Fantasy	Computers: Programming	Music: Techno	Dining Out
Books: Sci-Fi	Computers: Other	Music: Soundtrack	Movie Theaters
Books: Other	Music: Alternative	Music: Other	Shopping
Computers: Gaming	Music: Classical		Toys (all types)

Other Interests (that aren't listed):

Type of Computer, Operating System, Processor, Video Resolution:

Anything else I should know or you want to say?

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Most Content ©1999 Chromium Enterprises
Site Created and Maintained by Tuxedo TwO
Created on February 10, 1999 - Original on 8/30/98