Enrollment Form

Please fill out the following questions as completely as you can. All the information submitted will be used on our member profile page except STREET ADDRESS AND PHONE NUMBER. All that information will remain confidential with the Regents of the Xenaversity. Remember, this is all about you and we want to know all! PLEASE DO NOT TYPE ALL CAPS. Thanks.

Name (First & Last):  

Today's Date (IMPORTANT):  


Birthdate (Year Optional):

Street Address: (will not be disclosed)



Zip Code:   


Phone Number: (will not be disclosed)

URL to your Xena Website (if appicable): http://


YOUR FAVORITE XENA EPISODE/APPEARANCE (Listed below from Season 1 to 5)

What is your FAVORITE QUOTE from XWP (quote & character saying it)

Where did you hear about the Xenaversity of Minnesota?

What do you like most about the Xenaversity Website?

What would you like to see our our website? Suggestions, Comments, Critiques, Opinions

(OPTIONAL) Which of the following things do you think you could contribute as a member of the Xenaversity?

Male Female
You are in between the ages of.... 18 or under 19-25 26-35 36 and up
Do you think there is a subtext on Xena? Yes No It matters not
Are you able to provide a photo for our yearbook? Yes No
Please choose whether you want to be a local fan or a cyber fan. To get information about the different memberships, 
visit our About the Xenaversity Page.
$25 annual fee - (families: $35) Local Fan (Participate in Local Monthly Meetings/Events/Weekly Chats,
       Added to Mailing List & Profile Page) ALSO receive bi-monthly newsletter by mail
FREE - Cyber Fan (Participate in Weekly Chats, Added to Mailing List & Profile Page)

Please send me more information on creating a XENAVERSITY CAMPUS where I live (Example: Xenaversity of California!). This would include information on how to create a local Xena Fan club in my area, info on the charter and newsletters, etc. The Xenaversity of Minnesota started with 5 people, so go for it!!! Yes No
Please tell us a little about yourself, how you got into Xena, etc. This will be posted
under member profiles with your name (Limit 3-4 lines please):

By submitting your enrollment form, you agree to relinquish all personal reviews &  opinions, that are GIVEN freely to the XOM's web site, whether I am a future member or not. Also, any creative work such as artwork or fan fiction REMAINS YOUR PROPERTY; the Xenaversity is merely providing a way for Xenites to share in your talents. Whenever and wherever possible, the Xenaversity gives total credit to author/artist/etc. I understand that my personal web site link, fan ficion/artwork/etc and profile may be deleted from XOM's web site at my request at anytime."

You will be contacted as soon as possible about your profile, about joining our mailing list and about joining our chats. If you don't hear from us within a month's time, please email us directly as xenaversity@aol.com. Thanks.

ZY.Freedback.com: Stunning, fast, FREE!    
FREE feedback form powered by Freedback.com

Xenaversity Main Page