DQC Usage & Validation Agreement              

IMPORTANT!  Read "How to get validated" before completing this form.  The
instructions must be followed precisely.  Please print *clearly*!              

1. Reserved account name on DQC (e.g., jsmith):__________________________              

2. Name: ____________________________________________ 3. Date: __________              

4. Home address: ________________________________________________________              

   City:________________ State/Country:________ Zip/Postal code:_________              

5. Home phone: ________________  Work phone (optional): _________________              

6. Employer/School (optional): __________________________________________              

7. Job title (opt, class/grade level if school): ________________________              

8. Your primary non-DQC internet address, if wish to disclose it,

   (user@full.host.name): ________________________________________              

I understand and agree that:
  -  I am personally liable for all use of my DQC account;
  -  I will comply with the Terms of Service as posted on DQC;
  -  I will not engage in any illegal or legally questionable 
     activities via DQC, including "spidering" (hacking/cracking),
     serving unapproved copyrighted material (e.g., software,
     images, audio), harrassing other users (local or remote), etc.
  -  I will not engage in any commercial activity or any activity 
     that places undue load on DQC, and understand that limits of any 
     kind may be imposed without notice;
  -  I will limit my use of the Internet from DQC to the services that
     DQC offers and not add my own without approval from the system
     administrator;
  -  I will abide by NetNews network etiquette when sending any messages
     from DQC;
  -  I will cease any given use of DQC upon request by a DQC admininstrator;
  -  DQC is not a guaranteed service; it may disappear at any time; I
     will NOT hold DQC liable for any damages I incur through the
     use or lack of use of DQC.              

9.                            Your Signature:  ___________________________              

10. Select Validation method (MUST do EXACTLY per instructions):
[ ] Donation: Amount $__________  
    [ ]Check
    (payable to "Northern Media Corporation", write login name on check)
    [ ]Visa  [ ]Mastercard   Card#:___________________________
       Expiration Date:____________ 
[ ] In-Person (validator writes here: __________________________________)
[ ] Notarized below AND photocopy of valid photo ID
    Subscribed and sworn to before me on ______________     
    County/State:					
					__________________________
					Notary Public
    Commission expires: _________      				(seal)              

Return this form to:

Northern Media Corporation
179 NE Isaiah
Suite #2
Bend, OR 97701
USA