Form:Module questionnaire

Model Questionnaire

STILL WORKING ON THIS (ALBERT)

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}}
{{{author}}}
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 }} }} }}
<select tabindex="4" id="input_4_month" name="Item[date][month]" > <option value="January">January</option> <option value="February">February</option> <option value="March" selected="selected">March</option> <option value="April">April</option> <option value="May">May</option> <option value="June">June</option> <option value="July">July</option> <option value="August">August</option> <option value="September">September</option> <option value="October">October</option> <option value="November">November</option> <option value="December">December</option> </select>
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}}

add title=Add an opinion item Item

Author:	author
Source:	source
Date:	date
URL:	url
Quote:	quote

{{{end template}}}

Opinion Topic: 1

Position: 2

Stance: 3 {{{end template}}}

Reference Item name: 1 {{{end template}}}

Free text: free text

summary

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