Alumni Input 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="112085a3.jpg"> <div> <FONT SIZE="5" COLOR="#FFFFFF" FACE="Arial" ><B>                        Mobile Christian School - Home of the Leopards</B></FONT><B>    </B><B> |     </B><A HREF="index.htm" TARGET="_top" TITLE=" Mobile Christian"><U><B>home</B></U></A></div> <div> <A HREF="id625.htm" TARGET="_top" TITLE="Alumni"><U><B><IMG SRC="03b0e0e0.png" border=0 width="14" height="14" ALT="up" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A><B>   </B><IMG BORDER="0" SRC="1x1.gif" HEIGHT="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="14"><B>     </B><IMG BORDER="0" SRC="1x1.gif" HEIGHT="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="14"><B>  </B><A HREF="id875.htm" TARGET="_top" TITLE="Title 875"><U><B><IMG SRC="0300e0e0.png" border=0 width="14" height="14" ALT="next" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFFFFF" TEXT="#080000" background="113d2e83.jpg"> <bR> </td> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>Alumni Input Form</I></div> <bR> <div> In order to properly serve our alumni, we are creating a database that will allow us to communicate with those former students of Mobile Christian School.  If you graduated from Mobile Christian, please fill out the form below so that we can involve you in the Alumni Association as it evolves.</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="Title,FirstName,LastName,Suffix,Maiden,Nickname,Class,Occupation,Business Name,Business Address,Email,Home Address,Home Address Line 2,City,State,Zip,Phone,Fax,It's ok to share my information with others.,Comments"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thank you for registering with our Alumni Association!"><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="alumni Information has been submitted"><input type="hidden" name="tlx_EmailTo" value="parrish_williams@mobilechristian.org"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">Title:<br> <input type="text" name="Title" size="30" maxlength="100"></td> </tr> <tr> <td align="left">First Name:<br> <input type="text" name="FirstName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Last Name:<br> <input type="text" name="LastName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Suffix:<br> <input type="text" name="Suffix" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Maiden Name:<br> <input type="text" name="Maiden" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Nickname:<br> <input type="text" name="Nickname" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Class of:<br> <input type="text" name="Class" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Occupation:<br> <input type="text" name="Occupation" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Business Name:<br> <input type="text" name="Business Name" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Business Address:<br> <input type="text" name="Business Address" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Home Address:<br> <input type="text" name="Home Address" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Home Address Line 2:<br> <input type="text" name="Home Address Line 2" size="30" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Zip:<br> <input type="text" name="Zip" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td align="left">Fax Number:<br> <input type="text" name="Fax" size="14" maxlength="14"></td> </tr> <tr> <td> <input type="checkbox" name="It's ok to share my information with others." value="yes"> It's ok to share my information with others.</td> </tr> <tr> <td align="left">Please list highschool activities that you were involved with and any ideas you might have for the alumni association in this space!:<br> <textarea name="Comments" rows="10" cols="40"></textarea></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> </td> </tr></table></body>