The BioBricks Foundation:Membership: Difference between revisions
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* Access to unique volunteer opportunities | * Access to unique volunteer opportunities | ||
* Exclusive access to and discounts on limited-edition, custom-designed BBF "Swag"<br> | * Exclusive access to and discounts on limited-edition, custom-designed BBF "Swag"<br> | ||
* Membership fees waived for | * Membership fees waived for 2008<br> | ||
<br> | <br> | ||
Please take a moment to fill out the the form below:<br> | Please take a moment to fill out the the form below:<br> | ||
Revision as of 10:31, 11 January 2008
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Membership
action="http://en.groundspring.org/EmailNow/pub.php?module=WebSignup&cmd=subscribe"
method="POST">
<input type="hidden" value="steefypsgftqeqss" name="listIds" /> <input type="hidden" value="http://www.biobricks.org" name="gotoUrl" /> <input type="hidden" value="Return to the BBF Home Page" name="gotoText" /> <input type="hidden" value="yesRequired" name="status_firstName" /> <input type="hidden" value="yesRequired" name="status_lastName" /> <input type="hidden" value="yesOptional" name="status_street1" /> <input type="hidden" value="yesOptional" name="status_street2" /> <input type="hidden" value="yesOptional" name="status_city" /> <input type="hidden" value="yesOptional" name="status_state" /> <input type="hidden" value="yesOptional" name="status_zipcode" /> <input type="hidden" value="yesOptional" name="status_country" /> <input type="hidden" value="no" name="status_Comments" /> <input type="hidden" value="no" name="status_GeneralInfo" /> <input type="hidden" value="no" name="status_MemberSince" /> <input type="hidden" value="yesOptional" name="status_Org" /> <input type="hidden" value="yesOptional" name="status_Phone" /> <input type="hidden" value="no" name="status_Volunteer1" /> <input type="hidden" value="no" name="status_Volunteer2" /> <table border="0"> <tr><td>Email Address:</td> <td> <input name="email" type="text" /> *</td></tr> <tr><td>Subscribe to:</td> <td> <input name="listSelect_137794" type="checkbox" value="1" id="qf_cec424" checked="checked" /> BBF Membership </td></tr> <tr><td colspan="2"> </td></tr> <tr><td>First Name:</td> <td> <input type="text" name="firstName" /> *</td></tr> <tr><td>Last Name:</td> <td> <input type="text" name="lastName" /> *</td></tr> <tr><td>Organization:</td> <td> <input type="text" name="Org" /> </td></tr> <tr><td>Street 1:</td> <td> <input type="text" name="street1" /> </td></tr> <tr><td>Street 2:</td> <td> <input type="text" name="street2" /> </td></tr> <tr><td>City:</td> <td> <input type="text" name="city" /> </td></tr> <tr><td>State:</td> <td> <select name="state"> <option value="">Select</option> <option value="AK">Alaska</option> <option value="AL">Alabama</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PA">Pennsylvania</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VA">Virginia</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> <option value="DC">Washington DC</option> <option value="GU">Guam</option> <option value="PR">Puerto Rico</option> <option value="VI">Virgin Islands</option> </select> </td></tr> <tr><td>Zip Code / Postal Code:</td> <td> <input type="text" name="zipcode" /> </td></tr> <tr><td>Country:</td> <td> <select name="country"> <option value="">Select</option> <option value="AF">Afghanistan</option> <option value="AL">Albania</option> <option value="DZ">Algeria</option> <option value="AS">American Samoa</option> <option value="AD">Andorra</option> <option value="AO">Angola</option> <option value="AI">Anguilla</option> <option value="AQ">Antarctica</option> <option value="AG">Antigua and Barbuda</option> <option value="AR">Argentina</option> <option value="AM">Armenia</option> <option value="AW">Aruba</option> <option value="AU">Australia</option> <option value="AT">Austria</option> <option value="AZ">Azerbaijan</option> <option value="BS">Bahamas, The</option> <option value="BH">Bahrain</option> <option value="BD">Bangladesh</option> <option value="BB">Barbados</option> <option value="BY">Belarus</option> <option value="BE">Belgium</option> <option value="BZ">Belize</option> <option value="BJ">Benin</option> <option value="BM">Bermuda</option> <option value="BT">Bhutan</option> <option value="BO">Bolivia</option> <option value="BA">Bosnia and Herzegovina</option> <option value="BW">Botswana</option> <option value="BV">Bouvet Island</option> <option value="BR">Brazil</option> <option value="IO">British Indian Ocean Territory</option> <option value="VG">British Virgin Islands</option> <option value="BN">Brunei Darussalam</option> <option value="BG">Bulgaria</option> <option value="BF">Burkina Faso</option> <option value="MM">Burma</option> <option value="BI">Burundi</option> <option value="KH">Cambodia</option> <option value="CM">Cameroon</option> <option value="CA">Canada</option> <option value="CV">Cape Verde</option> <option value="KY">Cayman Islands</option> <option value="CF">Congo, Republic of the</option> <option value="TD">Chad</option> <option value="CL">Chile</option> <option value="CN">China</option> <option value="CX">Christmas Island</option> <option value="CC">Cocos (Keeling) Islands</option> <option value="CO">Colombia</option> <option value="KM">Comoros</option> <option value="CG">Congo, Democratic Republic of the</option> <option value="CK">Cook Islands</option> <option value="CR">Costa Rica</option> <option value="CI">Cote d'Ivoire</option> <option value="HR">Croatia</option> <option value="CU">Cuba</option> <option value="CY">Cyprus</option> <option value="CZ">Czech Republic</option> <option value="DK">Denmark</option> <option value="DJ">Djibouti</option> <option value="DM">Dominica</option> <option value="DO">Dominican Republic</option> <option value="TP">East Timor</option> <option value="EC">Ecuador</option> <option value="EG">Egypt</option> <option value="SV">El Salvador</option> <option value="GQ">Equatorial Guinea</option> <option value="ER">Eritrea</option> <option value="EE">Estonia</option> <option value="ET">Ethiopia</option> <option value="EU">European Union</option> <option value="FK">Falkland Islands (Islas Malvinas)</option> <option value="FO">Faroe Islands</option> <option value="FJ">Fiji</option> <option value="FI">Finland</option> <option value="FR">France</option> <option value="GF">French Guiana</option> <option value="PF">French Polynesia</option> <option value="TF">French Southern and Antarctic Lands</option> <option value="GA">Gabon</option> <option value="GM">Gambia</option> <option value="GE">Georgia</option> <option value="DE">Germany</option> <option value="GH">Ghana</option> <option value="GI">Gibraltar</option> <option value="GR">Greece</option> <option value="GL">Greenland</option> <option value="GD">Grenada</option> <option value="GP">Guadeloupe</option> <option value="GU">Guam</option> <option value="GT">Guatemala</option> <option value="GN">Guinea</option> <option value="GW">Guinea-Bissau</option> <option value="GY">Guyana</option> <option value="HT">Haiti</option> <option value="HM">Heard Island and McDonald Islands</option> <option value="VA">Holy See (Vatican City)</option> <option value="HN">Honduras</option> <option value="HK">Hong Kong (SAR)</option> <option value="HU">Hungary</option> <option value="IS">Iceland</option> <option value="IN">India</option> <option value="ID">Indonesia</option> <option value="IR">Iran</option> <option value="IQ">Iraq</option> <option value="IE">Ireland</option> <option value="IL">Israel</option> <option value="IT">Italy</option> <option value="JM">Jamaica</option> <option value="JP">Japan</option> <option value="JO">Jordan</option> <option value="KZ">Kazakhstan</option> <option value="KE">Kenya</option> <option value="KI">Kiribati</option> <option value="KP">Korea, North</option> <option value="KR">Korea, South</option> <option value="KW">Kuwait</option> <option value="KG">Kyrgyzstan</option> <option value="LA">Laos</option> <option value="LV">Latvia</option> <option value="LB">Lebanon</option> <option value="LS">Lesotho</option> <option value="LR">Liberia</option> <option value="LY">Libya</option> <option value="LI">Liechtenstein</option> <option value="LT">Lithuania</option> <option value="LU">Luxembourg</option> <option value="MO">Macao</option> <option value="MK">Macedonia, The Former Yugoslav Republic of</option> <option value="MG">Madagascar</option> <option value="MW">Malawi</option> <option value="MY">Malaysia</option> <option value="MV">Maldives</option> <option value="ML">Mali</option> <option value="MT">Malta</option> <option value="MH">Marshall Islands</option> <option value="MQ">Martinique</option> <option value="MR">Mauritania</option> <option value="MU">Mauritius</option> <option value="YT">Mayotte</option> <option value="MX">Mexico</option> <option value="FM">Micronesia, Federated States of</option> <option value="MD">Moldova</option> <option value="MC">Monaco</option> <option value="MN">Mongolia</option> <option value="MS">Montserrat</option> <option value="MA">Morocco</option> <option value="MZ">Mozambique</option> <option value="NA">Namibia</option> <option value="NR">Nauru</option> <option value="NP">Nepal</option> <option value="AN">Netherlands Antilles</option> <option value="NL">Netherlands</option> <option value="NC">New Caledonia</option> <option value="NZ">New Zealand</option> <option value="NI">Nicaragua</option> <option value="NE">Niger</option> <option value="NG">Nigeria</option> <option value="NU">Niue</option> <option value="NF">Norfolk Island</option> <option value="MP">Northern Mariana Islands</option> <option value="NO">Norway</option> <option value="OM">Oman</option> <option value="PK">Pakistan</option> <option value="PW">Palau</option> <option value="PS">Palestinian Territory, Occupied</option> <option value="PA">Panama</option> <option value="PG">Papua New Guinea</option> <option value="PY">Paraguay</option> <option value="PE">Peru</option> <option value="PH">Philippines</option> <option value="PN">Pitcairn Islands</option> <option value="PL">Poland</option> <option value="PT">Portugal</option> <option value="PR">Puerto Rico</option> <option value="QA">Qatar</option> <option value="RO">Romania</option> <option value="RU">Russian Federation</option> <option value="RW">Rwanda</option> <option value="RE">Réunion</option> <option value="SH">Saint Helena</option> <option value="KN">Saint Kitts and Nevis</option> <option value="LC">Saint Lucia</option> <option value="PM">Saint Pierre and Miquelon</option> <option value="VC">Saint Vincent and the Grenadines</option> <option value="WS">Samoa</option> <option value="SM">San Marino</option> <option value="SA">Saudi Arabia</option> <option value="SN">Senegal</option> <option value="SC">Seychelles</option> <option value="SL">Sierra Leone</option> <option value="SG">Singapore</option> <option value="SK">Slovakia</option> <option value="SI">Slovenia</option> <option value="SB">Solomon Islands</option> <option value="SO">Somalia</option> <option value="ZA">South Africa</option> <option value="GS">South Georgia and the South Sandwich Islands</option> <option value="ES">Spain</option> <option value="LK">Sri Lanka</option> <option value="SD">Sudan</option> <option value="SR">Suriname</option> <option value="SJ">Svalbard</option> <option value="SZ">Swaziland</option> <option value="SE">Sweden</option> <option value="CH">Switzerland</option> <option value="SY">Syria</option> <option value="ST">São Tomé and Príncipe</option> <option value="TW">Taiwan</option> <option value="TJ">Tajikistan</option> <option value="TZ">Tanzania</option> <option value="TH">Thailand</option> <option value="TG">Togo</option> <option value="TK">Tokelau</option> <option value="TO">Tonga</option> <option value="TT">Trinidad and Tobago</option> <option value="TN">Tunisia</option> <option value="TR">Turkey</option> <option value="TM">Turkmenistan</option> <option value="TC">Turks and Caicos Islands</option> <option value="TV">Tuvalu</option> <option value="UG">Uganda</option> <option value="UA">Ukraine</option> <option value="AE">United Arab Emirates</option> <option value="GB">United Kingdom</option> <option value="US">United States</option> <option value="UM">United States Minor Outlying Islands</option> <option value="UY">Uruguay</option> <option value="UZ">Uzbekistan</option> <option value="VU">Vanuatu</option> <option value="VE">Venezuela</option> <option value="VN">Vietnam</option> <option value="VI">Virgin Islands, U.S.</option> <option value="WF">Wallis and Futuna</option> <option value="EH">Western Sahara</option> <option value="YE">Yemen</option> <option value="YU">Yugoslavia</option> <option value="ZM">Zambia</option> <option value="ZW">Zimbabwe</option> </select> </td></tr> <tr><td>Phone Number:</td> <td> <input type="text" name="Phone" /> </td></tr> <tr> <td></td> <td><input type="submit" value="Subscribe"></td> </tr> </table> <p>[*] Fields marked with an asterisk are required. </form>
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