Change Contact Information: Difference between revisions
From CSDMS
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===Change your contact information=== | ===Change your contact information=== | ||
Moved or found another job? ''Please let us know'' | Moved or found another job? ''Please let us know''! | ||
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. | |||
An email confirmation will be sent to you within 5 working days. | |||
Thank you in advance for your time! | |||
<table width=550> | <table width=550> |
Revision as of 18:47, 23 December 2010
Change your contact information
Moved or found another job? Please let us know!
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. An email confirmation will be sent to you within 5 working days. Thank you in advance for your time!
{{#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}} |
Institute / Organization: | {{#input:type=text|name=Institute|size=40}} |
Department: | {{#input:type=text|name=Department|size=40}} |
Postal address 1: | {{#input:type=text|name=Postal address 1|size=40}} |
Postal address 2: | {{#input:type=text|name=Postal address 2|size=40}} |
Town/City: | {{#input:type=text|name=Town/City}} |
Postal code: | {{#input:type=text|name=Postal code|size=15}} |
State: | {{#input:name=State|type=select|value=|
|
Country: | {{#input:type=text|name=Country}} |
Email address: | {{#input:type=text|name=Email address}} |
Phone: | {{#input:type=text|name=Phone|size=15}} |
Fax: | {{#input:type=text|name=Fax|size=15}} |
Member of workgroup: | {{#input:type=checkbox|name=terrestrial}} Terrestrial |
More than one option possible | {{#input:type=checkbox|name=Coastal}} Coastal |
{{#input:type=checkbox|name=Marine}} Marine | |
{{#input:type=checkbox|name=EKT}} Education & Knowledge Transfer | |
{{#input:type=checkbox|name=Cyberinformatics}} Cyberinformatics | |
And / or member of a Focus Research Group: | {{#input:type=checkbox|name=Hydrology}} Hydrology Focus research group |
More than one option possible | {{#input:type=checkbox|name=Carbonate}} Carbonate Focus research group |
{{#input:type=checkbox|name=Chesapeake}} Chesapeake Focus research group | |
{{#input:type=submit|value=Submit form}} |