Date: Fri, 19 Dec 1997 00:45:01 GMT Server: NCSA/1.5.2 Last-modified: Fri, 24 Oct 1997 19:59:50 GMT Content-type: text/html Content-length: 3057
First Name: Last Name: Social Security #: Spouse's First Name: Social Security #: Address 1: Address 2: City: State: Zip Code: Home Phone: Bus. Phone: Birthdate: Spouse's Birthdate: Anniversary Date: Property where you plan to play next: Boulder Station, Las Vegas Palace Station, Las Vegas Station Casino Kansas City Station Casino St. Charles Sunset Station, Las Vegas Texas Station, Las Vegas