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| ===Change your contact information=== | | ===Change your contact information=== |
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| Moved or found another job? ''Please let us know''! | | Moved or found another job? ''Please let us know''! |
| | <BR><BR><BR><BR> |
| | Take a few minutes to Email the following information to [mailto:csdmsweb@colorado.edu csdmsweb@colorado.edu]: |
| | Copy / paste:<br> |
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| Take a few minutes to complete the form below. Once completed, make sure that you submit the form by pressing the submission button at the bottom of this page.
| | I do / did have a (previous) affiliation with the Univ. of Colorado:(Yes/No)<br> |
| An email confirmation will be sent to you within 5 working days.
| | First name:<br> |
| Thank you in advance for your time!
| | Last name:<br> |
| | | Institute / Organization:<br> |
| <table width=550>
| | Department:<br> |
| {{#form:method=POST|}}
| | Postal address 1:<br> |
| <tr><td>{{#input:type=hidden|name=formmailer|value=formmailer}}</td><td>{{#input:type=hidden|name=title|value=Updating contact information thank you}}</td></tr>
| | Postal address 2:<br> |
| <tr><td>First Name:</td><td>{{#input:type=text|name=First name }}</td></tr>
| | City:<br> |
| | | Postal code:<br> |
| <tr><td>Last Name:</td><td>{{#input:type=text|name=Last name}}</td></tr>
| | State / Country:<br> |
| | | Email address:<br> |
| <tr><td>Institute / Organization:</td><td> {{#input:type=text|name=Institute|size=40}}</td></tr>
| | Phone:<br> |
| | | Fax:<br> |
| <tr><td>Department:</td><td>{{#input:type=text|name=Department|size=40}}</td></tr>
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| <tr><td>Postal address 1:</td><td>{{#input:type=text|name=Postal address 1|size=40}}</td></tr>
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| <tr></tr>
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| <tr><td>Postal address 2:</td><td>{{#input:type=text|name=Postal address 2|size=40}}</td></tr>
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| <tr><td>Town/City:</td><td> {{#input:type=text|name=Town/City}}</td></tr>
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| <tr><td>Postal code:</td><td>{{#input:type=text|name=Postal code|size=15}}</td></tr>
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| <tr><td>State:</td><td>{{#input:name=State|type=select|value={{{State|}}}|
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| *State:
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| *NO STATE
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| *Alabama
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| *Alaska
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| *Arizona
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| *Arkansas
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| *California
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| *Colorado
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| *Connecticut
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| *District of Columbia
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| *Delaware
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| *Florida
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| *Georgia
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| *Hawaii
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| *Idaho
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| *Illinois
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| *Indiana
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| *Iowa
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| *Kansas
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| *Kentucky
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| *Louisiana
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| *Maine
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| *Maryland
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| *Massachusetts
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| *Michigan
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| *Minnesota
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| *Mississippi
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| *Missouri
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| *Montana
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| *Nebraska
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| *Nevada
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| *New Hampshire
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| *New Jersey
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| *New Mexico
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| *New York
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| *North Carolina
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| *North Dakota
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| *Ohio
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| *Oklahoma
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| *Oregon
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| *Pennsylvania
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| *Rhode Island
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| *South Carolina
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| *South Dakota
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| *Tennessee
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| *Texas
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| *Utah
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| *Vermont
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| *Virginia
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| *Washington
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| *West Virginia
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| *Wisconsin
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| *Wyoming
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| }}</td></tr>
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| <tr><td>Country:</td><td>{{#input:type=text|name=Country}}</td></tr>
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| <tr><td>Email address:</td><td>{{#input:type=text|name=Email address}}</td></tr>
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| <tr><td>Phone:</td><td> {{#input:type=text|name=Phone|size=15}}</td></tr>
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| <tr><td>Fax:</td><td> {{#input:type=text|name=Fax|size=15}}</td></tr>
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| <tr><td>Member of workgroup:</td><td>{{#input:type=checkbox|name=terrestrial}} Terrestrial</td></tr>
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| <tr><td></td><td>{{#input:type=checkbox|name=Coastal}} Coastal</td></tr>
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| <tr><td>(<i>More than one option possible</i>)</td><td>{{#input:type=checkbox|name=Marine}} Marine</td></tr>
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| <tr><td></td><td>{{#input:type=checkbox|name=EKT}} Education & Knowledge Transfer</td></tr>
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| <tr><td></td><td>{{#input:type=checkbox|name=Cyberinformatics}} Cyberinformatics</td></tr>
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| | |
| <tr><td><i><b>And / or</b> </i> <br>member of a Focus Research Group:</td><td><br>{{#input:type=checkbox|name=Hydrology}} Hydrology Focus research group</td></tr>
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| <tr><td></td><td>{{#input:type=checkbox|name=Carbonate}} Carbonate Focus research group</td></tr>
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| <tr><td>(<i>More than one option possible</i>)</td><td>{{#input:type=checkbox|name=Chesapeake}} Chesapeake Focus research group</td></tr>
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| <tr><td></td><td>{{#input:type=checkbox|name=CZ}} Critical Zone Focus research group</td></tr>
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| <tr><td></td><td>{{#input:type=checkbox|name=HumanDimensions}} Human Dimensions Focus research group</td></tr>
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| <tr><td></td><td>{{#input:type=checkbox|name=Geodynamics}} Geodynamics Focus research group</td></tr>
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| <tr><td><i><b>And / or</b> </i> <br>member of an Initiative :</td><td><br>{{#input:type=checkbox|name=CoastalVulnerability}} Coastal Vulnerability Initiative</td></tr>
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| <tr><td></td><td>{{#input:type=checkbox|name=ContinentalMargin}} Continental Margin Initiative</td></tr>
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| <tr><td></td><td>{{#input:type=submit|value=Submit form}}</td></tr>
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| {{#formend:}}
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| </table>
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| [[Category:Form]]
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