Membership form

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" background="09ed05a3.jpg"> <div> <FONT SIZE="2" COLOR="#000000" FACE="Arial" ><B>          </B></FONT><FONT SIZE="5" COLOR="#000000" FACE="Arial" ><B>                             </B></FONT><FONT SIZE="5" COLOR="#FF0000" FACE="Arial" ><B>    Reading Council for Voluntary Youth Service</B></FONT><B>    </B><B> </B></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000" background="09fd2123.jpg"> <div> <A HREF="id17.htm" TARGET="_top" TITLE="What is RCVYS?"><U><B>What is RCVYS?</B></U></A></div> <div> <B><IMG BORDER="0" SRC="Symb075c00b700c8ff000000.png" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Membership form</B></div> <div> <A HREF="id84.htm" TARGET="_top" TITLE="CYPSP database form"><U><B>CYPSP database form</B></U></A></div> <div> <A HREF="id24.htm" TARGET="_top" TITLE="RCVYS Meetings"><U><B>RCVYS Meetings</B></U></A></div> <div> <A HREF="id85.htm" TARGET="_top" TITLE="Bursary Fund"><U><B>Bursary Fund</B></U></A></div> <div> <A HREF="id74.htm" TARGET="_top" TITLE="Trailblazers"><U><B>Trailblazers</B></U></A></div> <div> <A HREF="id34.htm" TARGET="_top" TITLE="Finding Funding"><U><B>Finding Funding</B></U></A></div> <div> <A HREF="id49.htm" TARGET="_top" TITLE="Child Protection"><U><B>Child Protection</B></U></A></div> <div> <A HREF="id46.htm" TARGET="_top" TITLE="CRB checks"><U><B>CRB checks</B></U></A></div> <div> <A HREF="id48.htm" TARGET="_top" TITLE="Glossary (under construction)"><U><B>Glossary (under construction)</B></U></A></div> <div> <A HREF="id96.htm" TARGET="_top" TITLE="National Agenda"><U><B>National Agenda</B></U></A></div> <div> <A HREF="id35.htm" TARGET="_top" TITLE="Related Links page under construction!"><U><B>Related Links - page under construction!</B></U></A></div> <div> <A HREF="id95.htm" TARGET="_top" TITLE="CYPSP Reps"><U><B>CYPSP Reps</B></U></A></div> <div> <A HREF="id36.htm" TARGET="_top" TITLE="Contact Us"><U><B>Contact Us</B></U></A></div> <bR> <div> <A HREF="index.htm" TARGET="_top" TITLE=" Reading Council for Voluntary Youth "><U><B>Home</B></U></A></div> <bR> </td> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>Membership form</I></div> <div> Please fill in the following membership form with your details. </div> <bR> <div>  <form action="http://csbmail.globalscape.com/cgi-bin/csbmail/csbmail.pl" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="GroupName,ContactName,ContactAddress,Telephone,TelephoneMob,Email,WebSite,GroupInfo,OtherInfo1,OtherInfo2,SubmittedBy,RCVYSMailingList"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thank you for your membership application. We'll be in touch with you shortly!"><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="RCVYS memerbship form"><input type="hidden" name="tlx_EmailTo" value="cathb@rcvys.org.uk"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">Group Name:<br> <input type="text" name="GroupName" size="100" maxlength="100"></td> </tr> <tr> <td align="left">Contact Name:<br> <input type="text" name="ContactName" size="100" maxlength="100"></td> </tr> <tr> <td align="left">Contact Address (for correspondance):<br> <input type="text" name="ContactAddress" size="100" maxlength="200"></td> </tr> <tr> <td align="left">Telephone:<br> <input type="text" name="Telephone" size="30" maxlength="30"></td> </tr> <tr> <td align="left">Telephone (mobile):<br> <input type="text" name="TelephoneMob" size="30" maxlength="30"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="100" maxlength="100"></td> </tr> <tr> <td align="left">Web site (if any):<br> <input type="text" name="WebSite" size="100" maxlength="100"></td> </tr> <tr> <td align="left">Nature of work with children or young people:<br> <textarea name="GroupInfo" rows="5" cols="100"></textarea></td> </tr> <tr> <td align="left">Please give details of when & where you meet:<br> <input type="text" name="OtherInfo1" size="100" maxlength="200"></td> </tr> <tr> <td align="left">Please give details of any membership criteria (e.g age, gender etc):<br> <input type="text" name="OtherInfo2" size="100" maxlength="200"></td> </tr> <tr> <td align="left">Please give your own name if you are not the contact name above:<br> <input type="text" name="SubmittedBy" size="100" maxlength="100"></td> </tr> <tr> <td> <input type="checkbox" name="RCVYSMailingList" value="yes"> Please tick this box if you do NOT wish to to be included on the RCVYS mailing list to be kept up to date with events, news and opportunities such as funding and training.*</td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> <bR> <div> * Please note that all member organisations will still receive notice of RCVYS's ordinary meetings and it's Annual General Meeting. </div> <bR> <div> You can unsubscribe from the mailing list at any time by sending an email to news-unsubscribe@rcvys.org.uk</div> <bR> <bR> <div> If you want to send any further information about your organisation, please use contact details on the <A HREF="id36.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A> page</div> <bR> </td> </tr></table></body>