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Preferences Form

 

What is this used for? This form is for collecting contact and preference information for Ring 216 Members and guests. Members can indicate whether they want to appear in the online directory and/or in the printed directory, how to be contacted, and what their magical interests are. Information on this form is submitted in an unsecure e-mail to the webmaster of Ring 216 - it is NOT stored on this (or any) public server. See the NOTE below for further information. To keep things as private as possible there is no method to check to see what information we have on file for you. If you later discover you want to change even one item, please fill out the entire form.

Even if you are NOT a Ring 216 member, and not planning to become one you may still use this form to receive notification about events, lectures, and other business, please check this box and fill out the rest of the form.  I am NOT a member - but I want to receive updates.

Do you want to get off the list altogether? If so CLICK HERE instead.

Required fields are shown in red*.

IBM Number*   (if unknown enter either "none" or "pending")
Name* First      Last    
Address Street*  
Street (cont)
City*  
State*    Zip*   
Phone Day* (business) e.g. (408) 267-9676 x1234
Evening (home)
Mobile
FAX
Contact E-mail* (primary for magic)
Alt. E-mail (e.g. business or personal)
AOL IM
Yahoo IM
ICQ IM
MSN IM
Web Pages Magic http://
Personal http://
Preferences Newsletter Send me a printed newsletter (please only request if no e-mail available)
Email Opt*  I prefer plain text HTML PDF (portable document format) email.

Notify me about  ALL Things Magic
       or
I want to receive information about::
   Club Meetings/Info  Club Events/News  Club Newsletter
   Bay Area Magic Events  Sales/Auctions
   Other miscellaneous magic info.

Stage Name
Printed Directory

Publish me in the Ring 216 printed Directory and include my

Address
Instant Messenger IDs Web Page info
Phone: Day  Evening  Mobile FAX
E-Mail: Primary Alternate e-mail

Online Directory

Publish me in the Ring 216 ONLINE directory. Include:

Address
Instant Messenger IDs  Web Page info
Phone: Day  Evening  Mobile FAX
E-Mail: Primary Alternate e-mail

Interests

Tell us about yourself: [check all that apply]

I am most interested / skilled in these types of magic:
Card Coin  Mentalism Hypnotism  Silk  Dove  Escape
Bizarre Comedy  or Other:

I perform in these venues
Close-up  Parlor  Platform  Stage Street  Walk-Around

I prefer to work with:
Young Children  Pre-teens  Teens  Adults  Seniors

Over the past year I have worked as paid performer

Comments

Got something specific you'd like to add?

NOTE:

The information you submit here will ONLY be used in the manner you expect - that is only for IBM Ring 216 club business. Specifically, your name, address and other information will not be provided to anyone who is not a member of the club for any purpose. If you elect to be published online or in the printed directory, only the information you elect to reveal will be provided to club members.

If you choose to publish your information in the ONLINE directory we do take precautions to obscure your personal data from "SPAMbots".

Use "quick fill" to pre-populate some fields.

 

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    Broken link? Problem?    Last updated Friday August 22, 2008 12:10 PM