CIRCA:Join page
From CIRCA
MarinDacos (Talk | contribs) (Created page with 'Please complete the following form to join centerNet. Your personal information will not be shown on the website—only the description and name of the organization with a link …') |
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Please complete the following form to join centerNet. Your personal information will not be shown on the website—only the description and name of the organization with a link to the website (if available). | Please complete the following form to join centerNet. Your personal information will not be shown on the website—only the description and name of the organization with a link to the website (if available). | ||
| - | Your Name | + | |
| - | Region | + | Your Name |
| - | Your Email | + | |
| - | Center Name | + | Region |
| - | Description of Center | + | |
| + | Your Email | ||
| + | |||
| + | Center Name | ||
| + | |||
| + | Description of Center | ||
| + | |||
Keywords | Keywords | ||
| + | |||
Website | Website | ||
| + | |||
RSS | RSS | ||
| + | |||
Phone | Phone | ||
| + | |||
Org. Fax | Org. Fax | ||
| + | |||
Center Email | Center Email | ||
| - | + | ||
| + | Provide at least one form of contact. | ||
| + | |||
Street Address | Street Address | ||
City | City | ||
| + | |||
State/Province | State/Province | ||
| + | |||
Zip Code | Zip Code | ||
| + | |||
Country | Country | ||
| + | |||
Info (anything else you'd like us to know) | Info (anything else you'd like us to know) | ||
| - | + | required | |
| + | |||
Powered by Business Directory for Wordpress | Powered by Business Directory for Wordpress | ||
| - | + | = Translation = | |
| - | + | == FRENCH == | |
| + | |||
| + | Complétez le formulaire ci-dessous pour rejoindre le réseau CenterNet. Vos informations personnelles ne seront pas visibles su rle site. Seule la description et le nom de votre centre seront publiés, avec un lien vers celui-ci (si disponible). | ||
| + | |||
| + | |||
| + | Votre nom | ||
| + | |||
| + | Region | ||
| + | |||
| + | Votre courriel | ||
| + | |||
| + | Nom du centre | ||
| + | |||
| + | Description du centre | ||
| + | |||
| + | Mots-clés | ||
| + | |||
| + | Site (URL) | ||
| + | |||
| + | Flux RSS | ||
| + | |||
| + | Numéro de téléphone | ||
| + | |||
| + | Fax | ||
| + | |||
| + | Courriel officiel du centre | ||
| + | |||
| + | Fournissez au moins une modalité de contact. | ||
| + | |||
| + | Rue | ||
| + | |||
| + | Ville | ||
| + | |||
| + | Etat/Province | ||
| + | |||
| + | Code postal | ||
| + | |||
| + | Pays | ||
| + | |||
| + | Informations supplémentaires que vous souhaitez nous transmettre | ||
| + | |||
| + | obligatoire | ||
Current revision as of 14:58, 30 September 2010
Please complete the following form to join centerNet. Your personal information will not be shown on the website—only the description and name of the organization with a link to the website (if available).
Your Name
Region
Your Email
Center Name
Description of Center
Keywords
Website
RSS
Phone
Org. Fax
Center Email
Provide at least one form of contact.
Street Address
City
State/Province
Zip Code
Country
Info (anything else you'd like us to know)
required
Powered by Business Directory for Wordpress
Translation
FRENCH
Complétez le formulaire ci-dessous pour rejoindre le réseau CenterNet. Vos informations personnelles ne seront pas visibles su rle site. Seule la description et le nom de votre centre seront publiés, avec un lien vers celui-ci (si disponible).
Votre nom
Region
Votre courriel
Nom du centre
Description du centre
Mots-clés
Site (URL)
Flux RSS
Numéro de téléphone
Fax
Courriel officiel du centre
Fournissez au moins une modalité de contact.
Rue
Ville
Etat/Province
Code postal
Pays
Informations supplémentaires que vous souhaitez nous transmettre
obligatoire
