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"Dead Beats" of America, **Submissions:**


To submit a Dead Beat for posting please enter the information below:
Photographs must be sent via e-mail. Please include a reference to your story.

This submission form is divided into the following sections:

Fill out the information in each section as requested. You will receive a confirmation message from me shortly.


PERSONAL INFORMATION --

(DO NOT USE ALL CAPS, PLEASE)
Please answer the following questions completely. Drop-down lists are provided where applicable.

  1. Do you have a Homepage?		 Yes	 No 
    if so please put your URL here: 
  1. The following are required for posting your dead beat?
    Name:	
    E-mail:	
    City:	
    State:	 
  2. Please enter other contact information below: (**NOT REQUIRED FOR POSTING**)
    Title:  
    Address:  
    Address Line 2:  
    City:  
    State:   Zip code:
    Phone:  
    Other:  
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Dead Beat Information: -- (Information Containing ''**'' is Required for posting)

  1. **Dead Beat's Name:	
  2. **Known Alias:		
  3. **Sex:			 Male  Female 
  4. **Date of Birth:		
  5. **Location of case:	(2 Letter State Abbr.)
  6. Last Known Address:	
    			
    			
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ADDITIONAL COMENTS --

(DO NOT USE ALL CAPS, PLEASE)
Discription:  Enter as much discriptive information as possible (i.e. Habits,
              favorite color, favorite drink, places known to frequent, jobs, 
              hangouts, known associates, education, smoker/non-smoker, etc.).
1. Height:     2. Weight:  
3. Hair Color:     (3) If Other:  
4. Eye Color:     (4) If Other  
5. Race:     (5) If Other  
6. Build:          
7. Scars / Tattoos:  
8. Other:  
   
   
   
   
   
9. Your Story:  
   
   
   
   
   
   
   
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FORM SUBMISSION

Thank you for taking the time to answer the questions completely.
Please check your submission for accuracy before you hit the submit button.
To add a photograph, use the e-mail address on the confirmation page.
Photographs should be in either; *.JPG, *.GIF, *.BMP, or *.TIF format. (JPG preferred)

Rate this page along with your submission: (** Optional)
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Was this Web site.................
Informative Somewhat informative Not Informative Needs Work

Check your submission before clicking Submit,To Return to the Top of the Page

PRESS ONCE ONLY, PLEASE
If error, please contact me via e-mail, Thanks


 
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The Author / Designer of this site ( M. S. Madden ) is a member of the:
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Copyright 1998-2000 [Maddog Creations/DataTrax]. All rights reserved.
Last Update: August 28, 2000 12:53:27 AM
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Disclaimer Notice:
This page is provided as a Public Service, by ^^Wav Master~~.
The profiles and phographs referenced are provided solely from responses by visitors to the site. The Site Designer / Producer, M. S. Madden (
^^Wav Master~~ ) makes no representations regarding the validity of any information contained herein, except that it reflects the submissions of those who have submitted responses.
The information provided is "as received" and ^^Wav Master is not liable for said information.
Any questions, complaints, or claims regarding the postings must be directed to the person or
persons submitting the information, not the owner of the site.
This page is provided for
Informational Purposes Only.

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