Kontakt oplysninger

Urmageren i Ryslinge
v/Ege Juul Nielsen
Højskolevej 8
5856 Ryslinge
Mail: urmageren@urirys.dk
Mobil: 28 68 23 29

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<TD>Fornavn</TD>

<TD><INPUT TYPE=TEXT SIZE=25 MAXLENGTH=100 NAME=”MemberFirstname” CLASS=”FAVALIDATE FAVALIDATENAME” VALUE=”” ID=”FOAD_FIRSTNAME” ONKEYUP=”foadInputValidate();”><DIV ID=”FOAD_FIRSTNAME_HIGHLIGHT” STYLE=”display: inline;”></DIV></TD>

</TR><TR>

<TD>Mellemnavn</TD>

<TD><INPUT TYPE=TEXT SIZE=25 MAXLENGTH=100 NAME=”MemberMiddlename” CLASS=”FAVALIDATE FAVALIDATENAME” VALUE=”” ID=”FOAD_MIDDLENAME” ONKEYUP=”foadInputValidate();”><DIV ID=”FOAD_MIDDLENAME_HIGHLIGHT” STYLE=”display: inline;”></DIV></TD>

</TR><TR>

<TD>Efternavn</TD>

<TD><INPUT TYPE=TEXT SIZE=25 MAXLENGTH=100 NAME=”MemberLastname” CLASS=”FAVALIDATE FAVALIDATENAME” VALUE=”” ID=”FOAD_LASTNAME” ONKEYUP=”foadInputValidate();”><DIV ID=”FOAD_LASTNAME_HIGHLIGHT” STYLE=”display: inline;”></DIV></TD>

</TR><TR>

<TD>Adresse</TD>

<TD><INPUT TYPE=TEXT SIZE=25 MAXLENGTH=100 NAME=”MemberAdress” CLASS=”FAVALIDATE FAVALIDATENAME” VALUE=”” ID=”FOAD_ADDRESS” ONKEYUP=”foadInputValidate();”><DIV ID=”FOAD_ADDRESS_HIGHLIGHT” STYLE=”display: inline;”></DIV></TD>

</TR><TR>

<TD>Postnr</TD>

<TD><INPUT TYPE=TEXT SIZE=4 MAXLENGTH=4 NAME=”MemberZip” CLASS=”FAVALIDATE FAVALIDATEZIP” VALUE=”” ID=”FOAD_ZIP” ONKEYUP=”foadInputValidate();”><DIV ID=”FOAD_ZIP_HIGHLIGHT” STYLE=”display: inline;”></DIV></TD>

</TR><TR>

<TD>By</TD>

<TD><INPUT TYPE=TEXT SIZE=25 MAXLENGTH=100 NAME=”MemberCity” CLASS=”FAVALIDATE FAVALIDATENAME” VALUE=”” ID=”FOAD_CITY” ONKEYUP=”foadInputValidate();”><DIV ID=”FOAD_CITY_HIGHLIGHT” STYLE=”display: inline;”></DIV></TD>

</TR><TR>

<TD>E-mail</TD>

<TD><INPUT TYPE=TEXT SIZE=25 MAXLENGTH=100 NAME=”MemberEmail” CLASS=”FAVALIDATE FAVALIDATEEMAIL” VALUE=”” ID=”FOAD_EMAIL” ONKEYUP=”foadInputValidate();”><DIV ID=”FOAD_EMAIL_HIGHLIGHT” STYLE=”display: inline;”></DIV></TD>

</TR><TR>

<TD>Mobilnr.</TD>

<TD><INPUT TYPE=TEXT SIZE=8 MAXLENGTH=8 NAME=”MemberMobile” CLASS=”FAVALIDATE FAVALIDATEPHONE” VALUE=”” ID=”FOAD_MOBILE” ONKEYUP=”foadInputValidate();”><DIV ID=”FOAD_MOBILE_HIGHLIGHT” STYLE=”display: inline;”></DIV></TD>

</TR><TR>

<TD>Fødselsdag</TD>

<TD><INPUT TYPE=TEXT SIZE=10 MAXLENGTH=10 NAME=”MemberBirth” CLASS=”FAVALIDATE FAVALIDATEDATE” VALUE=”” ID=”FOAD_BIRTH” ONKEYUP=”foadInputValidate();”> (dd.mm.åååå) <DIV ID=”FOAD_BIRTH_HIGHLIGHT” STYLE=”display: inline;”></DIV></TD>

</TR><TR>

<TD>Type</TD>

<TD><select name=”ProfileType”><option value=”0″ selected=””>Aktiv medlem</option><option value=”1″>Interressemedlem</option><option value=”2″>Virksomhed</option><option value=”3″>Forening</option></select></TD>

</TR><TR>

<TD>Kommentar</TD>

<TD><INPUT TYPE=TEXT SIZE=25 MAXLENGTH=100 NAME=”MemberComment” VALUE=””></TD>

</TR><TR>

<TD>Forældre mail</TD>

<TD><INPUT TYPE=TEXT SIZE=25 MAXLENGTH=100 NAME=”MemberExtra2″ VALUE=””></TD>

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<INPUT TYPE=”HIDDEN” NAME=”FOADCOPY” VALUE=”kasserer@mas-scenen.dk”>

<INPUT TYPE=”HIDDEN” NAME=”FOADACC” VALUE=”1653″>

<INPUT TYPE=”HIDDEN” NAME=”FOADCOS” VALUE=”1739″>

<INPUT TYPE=”HIDDEN” NAME=”FOADSEC” VALUE=”f98c309a915bd56f88748f9f544dd3b1″>

<INPUT TYPE=”HIDDEN” NAME=”FOADNOTSEC” VALUE=”0165345ytjhkghfdg324ddc17391:1:1:1:1:1:1:1:0:0:1:1:1:0:0:1:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:kasserer@mas-scenen.dk”>

<INPUT TYPE=”HIDDEN” NAME=”FOADELM” VALUE=”1:1:1:1:1:1:1:1:0:0:1:1:1:0:0:1:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:0:”>

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