ÿþ<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <html> <head> <title>Javeenbah Theatre Company Incorporated</title> <link rel="stylesheet" type="text/css" href="jav-style.css" /> <style type="text/css"> BODY { background-color:#ececeb; background-image: url(images/gold-bkg.jpg);FONT-SIZE: 12px; COLOR: #000000; FONT-FAMILY: Arial,Verdana, Helvetica, sans-serif;} H1 {font: bold 20px tahoma, Arial, Helvetica, sans-serif;color: maroon;} </style> </head> </head> <body > <center> <H1>Membership application form</H1> <b><i>(Submit this form online or If you prefer, you may complete, print and snail mail it with your cheque to: PO Box 1101&nbsp;&nbsp;Ashmore City&nbsp;&nbsp;Qld 4214)</b></i><br><br> <form action="javformmail.php" method="post" enctype= "multipart/form-data"><input type="hidden" name="recipient" value="web@javeenbah.org.au"><input type="hidden" name="subject" value="Membership application"><input type="hidden" name= "redirect" value="thanks.html"><!--<input type= "hidden" name="required" value="email,Name,phone"> <input type=hidden name="missing_fields_redirect" value="http://www.javeenbah.org.au/error.html"> --> <table summary="memform intro" align="center" width="800px" bgcolor="#cccccc" style="border-style: double; border-width: 5px; border-color: #000000; FONT-SIZE: 14px; COLOR: #000000; FONT-FAMILY: Arial,Verdana, Helvetica, sans-serif;}"> <tr><!--Row 1 --> <td colspan="4"><br><font color="maroon"> <b>Become a member of Javeenbah Theatre Company Inc and receive:</b></font> </td> </tr> <!-- Row 2 --> <tr> <td valign="top" colspan="4"> <div style="margin-left: 50px; margin-right: 20px"><img src= "images/staryel.gif" alt="*">Cheaper theatre tickets</div> </td> </tr> <tr><!-- Row 3 --> <td valign="top" colspan="43"> <div style="margin-left: 50px; margin-right: 20px"><img src= "images/staryel.gif" alt="*">Our monthly newsletter with info on upcoming productions and auditions</div> </td> </tr> <tr><!-- Row 4 --> <td valign="top" colspan="4"> <div style="margin-left: 50px; margin-right: 20px"><img src= "images/staryel.gif" alt="*">Voting rights at the AGM</div> </td> </tr> <tr><!-- Row 5 --> <td valign="top" colspan="4"> <div style="margin-left: 50px; margin-right: 20px"><img src= "images/staryel.gif" alt="*">A warm, fuzzy feeling because you've just joined a fantastically friendly community theatre group!</div> </td> </tr> <tr><!--Row 6 blank --> <td colspan="4"> </td> </tr> <tr><!-- Row 7 --> <td align="right">Your name:</td> <td colspan="3"><input type="text" name="Name"></td> </tr> <tr><!-- Row 8 --> <td valign="top" align="right">Your address:</td> <td><textarea name="Address" rows="3"></textarea></td> <td valign="top" align="right">Postal code:</td> <td valign="top"><input type="text" name="Postcode" size="4"> </td> </tr> <tr><!-- Row 9 --> <td align="right">E-mail:</td> <td><input type="text" name="email"></td> <td align="right">Home phone:</td> <td><input type="text" name="phone"></td> </tr> <tr><!-- Row 10 --> <td align="right">Mobile:</td> <td><input type="text" name="Mobile"></td> <td align="right">Occupation:</td> <td><input type="text" name="Job"></td> </tr> <tr><!-- Row 11 --> <td colspan="2" align="right">Are you renewing an existing membership?</td> <td>Yes<input type="radio" name="Renew" value="Y">    No<input type="radio" name="Renew" value="N"></td> <td>Member number: <input type="text" name="Memnum" size="2"> </td> </tr> <tr><!-- Row 12 --> <td colspan="2" align="right">Are you under the age of 18 years?</td> <td>Yes<input type="radio" name="Under 18" value="Y">    No<input type="radio" name="Under 18" value="N"></td> <td> </td> </tr> <tr><!-- Row 13 --> <td colspan="4" align="left"> <hr width="50%" size="2" align="center" style="color:#ff0000"> <div style="margin-left:20px; margin-right:5px"> <p>Membership subscription is $20 a year for full membership and $10 for people under 18. Subscriptions last for a maximum of 12 months and expire on 30 June each year. There is no part-year discount.<br> Please EFT your subscription to Javeenbah's bank, Bank of Queensland, BSB 124001, Account number 11151389, Account name Javeenbah Theatre Company Inc. Use your name or your membership number as the reference.<br> If you are paying or renewing your subscription by EFT please check this box: <input type="checkbox" name="Pay_EFT"></p> </div> <hr width="50%" size="2" align="center" style="color:#ff0000"> </td> </tr> <!-- Check here --> <tr><!-- Row 14 --> <td width="25%"><input type="checkbox" name="Act"> Acting</td> <td width="25%"><input type="checkbox" name="Dir"> Directing *</td> <td width="25%"><input type="checkbox" name="SM"> Stage manager *</td> <td width="25%"><input type="checkbox" name="Pub">Publicity</td> </tr> <tr><!-- Row 15 --> <td width="25%"><input type="checkbox" name="PA"> Production assistant</td> <td><input type="checkbox" name="Design"> Set design</td> <td><input type="checkbox" name="Plot"> Light/sound plot</td> <td><input type="checkbox" name="Ward"> Wardrobe</td> </tr> <tr><!-- Row 16 --> <td width="25%"><input type="checkbox" name="Choreo"> Choreography</td> <td><input type="checkbox" name="Dance"> Dancer</td> <td><input type="checkbox" name="Sing"> Singer</td> <td><input type="checkbox" name="Muso"> Musician</td> </tr> <tr><!-- Row 17 --> <td><input type="checkbox" name="Build"> Set construction</td> <td><input type="checkbox" name="Paint"> Set painting/dressing</td> <td><input type="checkbox" name="Crew"> Stage crew</td> <td width="25%"><input type="checkbox" name="MakeUp"> Makeup</td> </tr> <tr><!-- Row 18 --> <td width="25%"><input type="checkbox" name="FOH"> Front of house</td> <td width="25%"><input type="checkbox" name="Light"> Techs op</td> <td width="25%"><input type="checkbox" name="Prompt">Prompt</td> <td><input type="checkbox" name="Prop"> Props/furnishings</td> </tr> <tr><!-- Row 19 --> <td><input type="checkbox" name="Dress"> Dresser *</td> <td width="25%"><input type="checkbox" name="Admin"> Administration</td> <td width="25%"><input type="checkbox" name="BoxO"> Box office</td> <td><input type="checkbox" name="Clean"> Cleaning</td> </tr> <tr><!-- Row 20 --> <td> </td> <td colspan="2"><input type="checkbox" name="Cater">Catering</td> <td> </td> </tr> <tr><!-- Row 21 --> <td colspan="4"> <div style="margin-left:20px; font-size: 85%"> <p>* When a production involves children or young people under the age of 18 years, director, stage manager, dresser and any other person likely to be in a one-to-one situation with a child or young person will be required to hold a current Positive Notice Blue Card or equivalent.</p> <p>As required by Section 70 of the Associations Incorporation Act, Javeenbah Theatre advises prospective members that it has third party public liability insurance cover of $20,000,000.</p> </div> </td> </tr> <tr><!-- Row 22 --> <td colspan="2" align="center"><input type="reset" value= "Oops. A mistake? Click here to restart" style= "background-color:#ff0000; color:#ffffff"></td> <td colspan="2" align="center"><input type="submit" value= "All OK? Click here to send to Javeenbah" style= "background-color:#009900; color:#ffffff"></td> </tr> <tr><!-- Row 23 and last --> <td colspan="4" align="center"> </td> </tr> </table> </form> <p style="color: #000000; width:90%">Thank you for joining or renewing your membership with Javeenbah Theatre Company Inc! Your membership card will be sent to you shortly. <script language="JavaScript" type="text/javascript"> <!-- Begin if (window.print) { document.write('<form> ' + '<input type=button name=print value="PRINT FORM" ' + 'onClick="javascript:window.print()"><\/form>'); } // End --> </script> </p> </body> </html>