Form:Module questionnaire: Difference between revisions
From CSDMS
New page: ===Model Questionnaire=== Please take some time to complete the form below. Make sure that after you complete the questionnaire you submit the form by pressing the submission button at th... |
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Please take some time to complete the form below. Make sure that after you complete the questionnaire you submit the form by pressing the submission button at the bottom of this page. | Please take some time to complete the form below. Make sure that after you complete the questionnaire you submit the form by pressing the submission button at the bottom of this page. | ||
Thank you for your time in advance! | Thank you for your time in advance! | ||
<table width=550> | |||
{{#form:method=POST| | |||
<tr><td>{{#input:type=hidden|name=formmailer}}</td><td>{{#input:type=hidden|name=title|value=:Organization}}</td></tr> | |||
<tr><td>First Name:</td><td>{{#input:type=text|name=First name }}</td></tr> | |||
<tr><td>Last Name:</td><td>{{#input:type=text|name=Last name}}</td></tr> | |||
<tr><td> | |||
{{#input: type = hidden | name = content | value = <nowiki>{{#dpl:category={{test1 | test2}}}}</nowiki> }} | |||
{{#input:type = select | |||
| name = cat | |||
| *Select category {{#dpl: namespace = Category | mode = userformat | listseparators = ,\n }} | |||
}} | |||
}} | |||
<tr><td>Institute / Organization:</td><td> {{#input:type=text|name=Institute}}</td></tr><tr><td>Department:</td><td>{{#input:type=text|name=Department}}</td></tr><tr><td>Postal address 1:</td><td>{{#input:type=text|name=Postal address 1}}</td></tr><tr><td>Postal address 2:</td><td>{{#input:type=text|name=Postal address 2}}</td></tr><tr><td>Town/City:</td><td> {{#input:type=text|name=Town/City}}</td></tr><tr><td>Postal code:</td><td>{{#input:type=text|name=Postal code}}</td></tr><tr><td>State:</td><td>{{#input:type=text|name=State}}</td></tr><tr><td>Country:</td><td>{{#input:type=text|name=Country}}</td></tr><tr><td>Email address:</td><td>{{#input:type=text|name=Email address}}</td></tr><tr><td>Phone:</td><td> {{#input:type=text|name=Phone}}</td></tr><tr><td>Fax:</td><td> {{#input:type=text|name=Fax}}</td></tr><tr><td>Choose workgroup:<br><i>More than one option possible</i></td><td>{{#input:type=checkbox|name=terrestrial}} Terrestrial</td></tr><tr><td></td><td>{{#input:type=checkbox|name=Coastal}} Coastal</td></tr><tr><td></td><td>{{#input:type=checkbox|name=Marine}} Marine</td></tr><tr><td></td><td>{{#input:type=checkbox|name=EKT}} Coastal</td></tr><tr><td></td><td>{{#input:type=checkbox|name=Cyberinformatics}} Cyberinformatics</td> | |||
</tr><tr><td>Description of your CSDMS-related interests:<br><i>(max 300 characters)</i></td><td>{{#input:type=textarea|cols=40|rows=4|name=interest}} | |||
</td></tr><tr><td></td><td> | |||
{{#input:type=submit|value=Submit}} | |||
</td></tr> | |||
}} | |||
</table> | |||
Revision as of 17:56, 2 March 2008
Model Questionnaire
Please take some time to complete the form below. Make sure that after you complete the questionnaire you submit the form by pressing the submission button at the bottom of this page. Thank you for your time in advance!
{{#form:method=POST| }}| {{#input:type=hidden|name=formmailer}} | {{#input:type=hidden|name=title|value=:Organization}} |
| First Name: | {{#input:type=text|name=First name }} |
| Last Name: | {{#input:type=text|name=Last name}} |
|
{{#input: type = hidden | name = content | value = {{#dpl:category={{test1 | test2}}}} }} {{#input:type = select | name = cat | *Select category {{#dpl: namespace = Category | mode = userformat | listseparators = ,\n }} }} }}
| |
| Institute / Organization: | {{#input:type=text|name=Institute}} |
| Department: | {{#input:type=text|name=Department}} |
| Postal address 1: | {{#input:type=text|name=Postal address 1}} |
| Postal address 2: | {{#input:type=text|name=Postal address 2}} |
| Town/City: | {{#input:type=text|name=Town/City}} |
| Postal code: | {{#input:type=text|name=Postal code}} |
| State: | {{#input:type=text|name=State}} |
| Country: | {{#input:type=text|name=Country}} |
| Email address: | {{#input:type=text|name=Email address}} |
| Phone: | {{#input:type=text|name=Phone}} |
| Fax: | {{#input:type=text|name=Fax}} |
| Choose workgroup: More than one option possible | {{#input:type=checkbox|name=terrestrial}} Terrestrial |
| {{#input:type=checkbox|name=Coastal}} Coastal | |
| {{#input:type=checkbox|name=Marine}} Marine | |
| {{#input:type=checkbox|name=EKT}} Coastal | |
| {{#input:type=checkbox|name=Cyberinformatics}} Cyberinformatics | |
| Description of your CSDMS-related interests: (max 300 characters) | {{#input:type=textarea|cols=40|rows=4|name=interest}} |
{{#input:type=submit|value=Submit}}
|
