Pacific Coast Aeronauts

tag:blogger.com,1999:blog-47327312882675896042008-07-19T11:49:07.188-07:00Pacific Coast AeronautsL & Lnoreply@blogger.comBlogger1125tag:blogger.com,1999:blog-4732731288267589604.post-60152056550603624292006-10-28T07:49:00.000-07:002007-01-09T16:06:46.155-08:00PCA Membership Application<table id="table3" cellspacing="0" cellpadding="0" width="100%" border="0"><tbody><tr><td><b><span style="color:#000080;">FORM INSTRUCTIONS:<br />This is NOT A SUBMIT ONLINE form.<br />Complete, Print, and SnailMail. Include payment by Check</span></b></td></tr></tbody></table><br /><form action="--WEBBOT-SELF--" method="post"><input type="hidden" value="0" name="VTI-GROUP"> <table id="table1" style="BORDER-COLLAPSE: collapse" cellpadding="0" width="100%" border="0"><tbody><tr><td style="COLOR: #000080" valign="top" colspan="2"></td><td style="COLOR: #000080; TEXT-ALIGN: right" valign="top"></td><td style="COLOR: #000080; TEXT-ALIGN: center" valign="top"></td><td style="COLOR: #000080; TEXT-ALIGN: center" valign="top" width="33%"></td></tr><tr><td valign="top" bg colspan="2" style="color:#000080;"><p style="TEXT-ALIGN: center"><b><span style="font-size:85%;color:#ffffff;">Membership Type (s)</span></b></p></td><td style="TEXT-ALIGN: right;color:#000080;" valign="top" bg><p style="TEXT-ALIGN: center"><b><span style="font-size:85%;color:#ffffff;">Price</span></b></p></td><td style="TEXT-ALIGN: center;color:#000080;" valign="top" bg><p style="TEXT-ALIGN: center"><span style="font-size:85%;color:#ffffff;"><b>Quantity </b></span></p></td><td style="TEXT-ALIGN: center;color:#000080;" valign="top" width="33%" bg><b><span style="font-size:85%;color:#ffffff;">TOTAL AMOUNT</span></b></td></tr><tr><td valign="top" bgcolor="#000080" colspan="2"></td><td style="TEXT-ALIGN: right" valign="top" bgcolor="#000080"></td><td style="TEXT-ALIGN: center" valign="top" bgcolor="#000080"></td><td style="TEXT-ALIGN: center" valign="top" width="33%" bgcolor="#000080"></td></tr><tr><td valign="top" colspan="2"></td><td style="TEXT-ALIGN: right" valign="top"></td><td style="TEXT-ALIGN: center" valign="top"></td><td style="TEXT-ALIGN: center;color:#c0c0c0;" valign="top" width="33%" rowspan="14" ><br /><b><br /><br /><br />TOTAL DUE<br /><span style="font-size:85%;color:#008000;">$ </span></b><span style="color:#008000;"><input style="FONT-WEIGHT: 700" size="11" name="total"></span></td></tr><tr><td valign="top" colspan="2"><b>Membership</b></td><td style="TEXT-ALIGN: right" valign="top"><b>$ 20.00 </b></td><td style="TEXT-ALIGN: center" valign="top"><p style="TEXT-ALIGN: center"><input size="2" name="pilot25"></p></td></tr><tr><td valign="top" colspan="2"><blockquote><p><i>Additional Family Voting Members </i></p></blockquote></td><td style="TEXT-ALIGN: right" valign="top"><i>$ 10.00</i></td><td style="TEXT-ALIGN: center" valign="top"><input size="2" name="pilot10"></td></tr><tr><td valign="top" colspan="2"><b></b></td><td style="TEXT-ALIGN: right" valign="top"></td><td style="TEXT-ALIGN: center" valign="top"></td></tr><tr><td valign="top" colspan="2"><blockquote><p> </p></blockquote></td><td style="TEXT-ALIGN: right" valign="top"></td><td style="TEXT-ALIGN: center" valign="top"></td></tr><tr><td valign="top" colspan="2"><br /></td><td style="TEXT-ALIGN: right" valign="top"></td><td style="TEXT-ALIGN: center" valign="top"></td></tr><tr><td style="TEXT-ALIGN: center" valign="top" bgcolor="#c0c0c0" colspan="4"><b><br />Merchandise<br /></b></td></tr><tr><td valign="top"></td><td valign="top"></td><td style="TEXT-ALIGN: right" valign="top"></td><td style="TEXT-ALIGN: center" valign="top"></td></tr><tr><td valign="top">PCA Pin</td><td valign="top"></td><td style="TEXT-ALIGN: right" valign="top">$ 3.50</td><td style="TEXT-ALIGN: center" valign="top"><input size="2" name="em16"></td></tr><tr><td valign="top">PCA Patch</td><td style="TEXT-ALIGN: center" valign="top"><i><span style="font-size:78%;">Size(s)</span></i></td><td style="TEXT-ALIGN: right" valign="top">$ 4.50</td><td style="TEXT-ALIGN: center" valign="top"><input size="2" name="em17"></td></tr><tr><td valign="top">Polo Shirt<br /></td><td style="TEXT-ALIGN: center" valign="top"><input style="FONT-SIZE: 8pt" name="em21"></td><td style="TEXT-ALIGN: right" valign="top">$ 25.00</td><td style="TEXT-ALIGN: center" valign="top"><input size="2" name="em18"></td></tr><tr><td valign="top">Sweatshirt (100% Cotton)<br /></td><td style="TEXT-ALIGN: center" valign="top"><input style="FONT-SIZE: 8pt" name="em22"></td><td style="TEXT-ALIGN: right" valign="top">$ 25.00</td><td style="TEXT-ALIGN: center" valign="top"><input size="2" name="em19"></td></tr><tr><td valign="top">Sweatshirt (50/50)<br /></td><td style="TEXT-ALIGN: center" valign="top"><input style="FONT-SIZE: 8pt" name="em23"></td><td style="TEXT-ALIGN: right" valign="top">$ 20.00</td><td style="TEXT-ALIGN: center" valign="top"><input size="2" name="em20"></td></tr><tr><td valign="top"></td><td valign="top"></td><td style="TEXT-ALIGN: right" valign="top"></td><td style="TEXT-ALIGN: center" valign="top"></td></tr></tbody></table><table id="table2" style="BORDER-COLLAPSE: collapse" cellpadding="0" width="100%" border="0"><tbody><tr><td style="COLOR: #000080" valign="top"></td><td style="COLOR: #000080" valign="top" width="33%"></td><td valign="top" width="1" bgcolor="#000080"></td></tr><tr><td valign="top" bg style="color:#000080;"><p style="TEXT-ALIGN: center"><span style="font-size:85%;color:#ffffff;"><b>Name and Address</b></span></p></td><td valign="top" width="33%" bg style="color:#000080;"><p style="TEXT-ALIGN: center"><span style="font-size:85%;color:#ffffff;"><b>MAIL TO</b></span></p></td><td valign="top" width="1" bgcolor="#000080"></td></tr><tr><td valign="top" bgcolor="#000080"></td><td valign="top" width="33%" bgcolor="#000080"></td><td valign="top" width="1" bgcolor="#000080"></td></tr><tr><td valign="top"><b>Name<br /></b><input size="49" name="T6"><br /><b>Address<br /></b><input size="49" name="T7"><br /><b>City<br /></b><input size="49" name="T8"><br /><b>State<br /></b><input size="49" value="CA" name="T9"><br /><b>ZipCode<br /></b><input size="49" name="T10"><br /><b>Phone<br /></b><input size="49" name="T11"><br /><b>Email<br /></b><input size="49" name="T12"> </td><td valign="top" width="33%" style="color:#c0c0c0;"><b><span style="font-size:85%;"><br /></span></b><p><span style="font-size:85%;"><b><br />Linda Walton<br />Treasurer<br />Pacific Coast Aeronauts<br />1428 Maysun Court<br />Campbell, CA 95008<br /><br /></b></span>Phone:<br />408-378-7013<br /><br />Email: <a href="mailto:lindalwalton@earthlink.net">lindalwalton@earthlink.net</a><br /><br /></p></td><td valign="top" width="1" bgcolor="#c0c0c0"></td></tr></tbody></table></form>L & Lnoreply@blogger.com