<HTML> <HEAD> <TITLE>CVAC Hall Rental Request Form</title> <style type="text/css"> <!-- .style1 { font-size: 18px; color: #660066; } .style2 {color: #660066} .style3 { color: #006400; } body { background-color: #FFFFFF; } .style4 {color: #003300} .style5 {color: #3D577C} .style6 { color: #FFFFFF; } .style7 {color: #3d577c; } --> </style> <script language="javascript" src="cal2.js"> /* Xin's Popup calendar script- Xin Yang (http://www.yxscripts.com/) Script featured on/available at http://www.dynamicdrive.com/ This notice must stay intact for use */ </script> <script language="javascript" src="cal_conf2.js"></script> <meta http-equiv="Content-Type" content="text/html; charset=unicode"></head> <body> <h1 align="center" class="style3"><img src="images/Logo.gif" alt="Logo" width="92" height="72"><span class="style5">Canadochly Valley Ambulance Club</span></h1> <form action="" method="post" name="form2" class="style5"> <label></label> </form> <h2 align="center" class="style5">Hall Rental Information Request Form</h2> <p class="style2"> <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <form action="thanks.php" method="POST" name="rent" class="style2"> <table width="100%"><tr> <td width="969" valign="top"> <p class="style7">NAME: <INPUT NAME="NAME" TYPE="text" VALUE="" SIZE=40 MAXLENGTH=40> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;EMAIL: <INPUT NAME="EMAIL" TYPE="text" VALUE="" SIZE=30 MAXLENGTH=30 id="EMAIL"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </p> <p class="style7">DAYTIME PHONE: <input name="DAYPHONE" type="text" size=15 maxlength=15 id="DAYPHONE"> &nbsp;&nbsp;&nbsp;EVENING PHONE: <input name="NIGHTPHONE" type="text" size=15 maxlength=15 id="NIGHTPHONE"> <BR> </p> <p class="style7"> <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <HTML> <!-- @page { size: 8.5in 11in; margin: 0.79in } P { margin-bottom: 0.08in } --> <BODY DIR="LTR"> </p> <p align="center" class="style7"><em><U><strong>PLEASE FILL THIS FORM OUT AS COMPLETELY AS POSSIBLE </strong></U></em> </p> <p class="style7">TYPE OF OCCASION:&nbsp; <label> <select name="OCCASION" size="1" id="Type of Change"> <option>Wedding</option> <option>Anniversary</option> <option>Birthday</option> <option>Retirement</option> <option>Other</option> </select></label> <br> <BR> NUMBER OF GUESTS: <INPUT NAME="GUESTS" TYPE="text" SIZE=10 MAXLENGTH=3 id="GUESTS"> &nbsp;&nbsp;&nbsp;</p> <p class="style7">FIRST CHOICE DATE: <INPUT TYPE="text" NAME="FIRST DATE" VALUE="" SIZE=25 id="FIRST DATE"> <small><a href="javascript:showCal('Calendar1')">Select Date</a></small> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; TIME <select name="TIME2" size="1" id="TIME2"> <option>7 AM</option> <option>8 AM</option> <option>9 AM</option> <option>10 AM</option> <option>11 AM</option> <option>Noon</option> <option>1 PM</option> <option>2 PM</option> <option>3 PM</option> <option>4 PM</option> <option>5 PM</option> <option>6 PM</option> <option>7 PM</option> <option>8 PM</option> <option>9 PM</option> <option>10 PM</option> </select> until <select name="UNTIL" size="1" id="UNTIL"> <option selected>8 AM</option> <option>9 AM</option> <option>10 AM</option> <option>11 AM</option> <option>Noon</option> <option>1 PM</option> <option>2 PM</option> <option>3 PM</option> <option>4 PM</option> <option>5 PM</option> <option>6 PM</option> <option>7 PM</option> <option>8 PM</option> <option>9 PM</option> <option>10 PM</option> <option>11 PM</option> <option>Midnight</option> <option>1 AM</option> <option>2 AM</option> </select> <br> <BR> SECOND CHOICE DATE: <INPUT NAME="SECOND DATE" TYPE="text" SIZE=21 MAXLENGTH=20 id="SECOND DATE"> <small><a href="javascript:showCal('Calendar2')">Select Date</a></small> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; TIME: <select name="SECONDTIME" size="1" id="SECONDTIME"> <option>7 AM</option> <option>8 AM</option> <option>9 AM</option> <option>10 AM</option> <option>11 AM</option> <option>Noon</option> <option>1 PM</option> <option>2 PM</option> <option>3 PM</option> <option>4 PM</option> <option>5 PM</option> <option>6 PM</option> <option>7 PM</option> <option>8 PM</option> <option>9 PM</option> <option>10 PM</option> </select> until <select name="SECONDUNTIL" size="1" id="SECONDUNTIL"> <option selected>8 AM</option> <option>9 AM</option> <option>10 AM</option> <option>11 AM</option> <option>Noon</option> <option>1 PM</option> <option>2 PM</option> <option>3 PM</option> <option>4 PM</option> <option>5 PM</option> <option>6 PM</option> <option>7 PM</option> <option>8 PM</option> <option>9 PM</option> <option>10 PM</option> <option>11 PM</option> <option>Midnight</option> <option>1 AM</option> <option>2 AM</option> </select> </p> <p class="style7"> CATERING NEEDS: <INPUT NAME="CATERING NEEDS" TYPE="text" SIZE=50 MAXLENGTH=50 id="CATERING NEEDS"> <br> <br> WILL YOU NEED ACCESS TO THE HALL FOR SET-UP PRIOR TO THE EVENT? : <label> <select name="PRIOR ACCESS NEEDED" id="PRIOR ACCESS NEEDED"> <option>Yes</option> <option>No</option> </select> </label> <br> <BR> WHEN? <INPUT NAME="WHEN BEFOREHAND" TYPE="text" SIZE=100 MAXLENGTH=100 id="WHEN BEFOREHAND"> <br> <BR> HOW DID YOU LEARN THAT THE HALL WAS AVAILABLE FOR RENTAL? : <select name="HOW LEARNED ABOUT HALL RENTAL" id="HOW LEARNED ABOUT HALL RENTAL"> <option>Friend</option> <option>Club Member</option> <option>Website</option> <option>Newspaper Article</option> <option>Other</option> </select> <BR> <BR> SPECIAL NEEDS:</p> <p class="style4"> <span class="style7"> <textarea name="SPECIAL NEEDS" cols="100" rows="8" id="SPECIAL NEEDS"></textarea> </span><span class="style6"> </span> </p></td> </tr> <tr><td align=center> <input type="SUBMIT" name="Status of Request" value="Submit Form">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input type="button" name="PRINT" id="PRINT" value="Print Form" onClick="window.print()" > </td></tr></table> </FORM> <span class="style2"> <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <HTML> <!-- @page { size: 8.5in 11in; margin: 0.79in } P { margin-bottom: 0.08in } --> </span> </body>