Jump to content
RemedySpot.com

ZapGallery

Rate this topic


Guest guest

Recommended Posts

Hi there....

I am finally getting to rebuilding of Zap•Gallery. Your BIO is

missing. Can you please take a few minutes to complete and ship this

form? If you have a new picture... (JPG preferred) send it as an

attachment to a reply to this note

Those of you on the Zap•List... we may/may not have your materials.

Ship form and picture ASAP if you want to appear in the ZapGallery.

Thanks.

Stay well....

Duffey

AOL users.... if garbled... go to this URL:

http://www.ZapLife.org/galleryform.htm

Zapper Gallery Data Form

Send picture for use in gallery as an EMail

attachment (JPG preferred) to Duffey@...

Caption to go with picture for Zapper Gallery:

Name

Nick Name

Excluding medical history, what is your life story?

EMail Address [OPTIONAL]

Personal WebPage [OPTIONAL]

City

Country/State

Date of Birth Month: Day: Year:

1st ICD Implant Month: Day: Year:

ICD Maker Model#4:

Implant# Total number of Zaps: Cardiac history leading to ICD implant:

Clever Anecdote/Philosophy to share?

Date Filed

Ignore page you will see after clicking button...

It is standard thank-you form when orders are submitted.

Copyright © 2001 by Duffey Cybercations Inc

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
×
  • Create New...