LOJBAN REGISTRATION

Name: ___________________________________________________________________
Street Address: _________________________________________________________
City, State, (Country), Zip: ____________________________________________
Home Phone: ______________________ Work Phone: __________________________
Internet Address: ____________________________________________________________________

My primary interest(s) in Lojban are (check any that are applicable):
____ linguistics applications/theory _____ computer applications
____ foreign language/linguistics education _____'international' language
____ other: ______________________________________________________________

Activity Level:
_____ I am not interested in further involvement. Please remove me from your active lists.
_____ (Level Observer - (default)
_____ (Level C) Active Supporter
_____ (Level D) Lojban Student
_____ (Level E) Lojban Practitioner

Email this form to lojban@lojban.org, or snail mail to

The Logical Language Group, Inc., 2904 Beau Lane, Fairfax VA 22031-1303 USA