CyberGuards - Application

CyberGuards - Protecting your rights on the internet.

Application For Chatroom Guard Position

Chatroom guards MUST be over 21 years of age.

Please complete the following information and submit the form. Due to the amount of requests received, you may not hear back from CyberGuards right away but please be assured that we have received your form. DO NOT submit more than one form. If you submit more than one form, we will assume you do not read directions and immediately deny your application.

Your Name:
Your Email:	Use your main email account not a generic email account (i.e., hotmail, yahoo, etc.)
Today's Date:
Your Street Address:
Your City:
State, Zip Code:
Country:
Your Date of Birth:	(mo/day/yr)
Your telephone number:
Your website information: (leave blank if none)	Website Name: Website URL: http://
Email Addresses you have used within the past 2 years:
Chatroom(s) Requesting to become a Guard in (if no preference, leave blank):
Chatroom nicknames you have used or currently use: (please specify current or old name & chatroom visited with name)
Do you have previous experience of this nature? YES NO (if yes, please explain below)

Additional Info you feel would be useful regarding this application:

Thank you, CyberGuards appreciates your desire to maintain internet integrity.