Fan Gallery Caption Info

Rev. 25-Apr-2002

CAPSULE BIO FORM

NAME:

E-mail address:

(Nickname):

Birthdate:

Locale:

Category or categories (e.g. Convention fan, Club fan, Fanzine archivist, Musician, Fan editor, etc.):

FGoH (or other GOH, please specify):

Con Committees:

Awards & Honors:

Clubs/Offices:

Fanzines:

Other Fanac:

First contact with fandom (year):

May we put your photo on our web site?

Photographer
Month/Year:
Rev.