Hillel of Metropolitan Detroit

<body> <head> <title>Hillel of Metropolitan Detroit</title> <meta name="Logname" content="Mailing List"> <meta name="description" content="Hillel of Metro Detroit is an organization of Jewish college students and young adults, 18-30 years old, in the metropolitan Detroit area."> <meta name="keywords" content="Hillel of Detroit, Hillel of Metro Detroit, Hillel of Metropolitan Detroit, HMD, Detroit Jewish Students, Wayne State University, WSU Hillel, Wayne State University Hillel Foundation, Jewish Students at Wayne State University"> </head><img src="top.gif" alt="Hillel of Metro Detroit" width="425" height="95"> <p><b><font size="+2"><font color="#FF0099">HMD Mailing List</font></font></b><font size="+2"></font></p> <p><font size="+2"><b>Join the HMD mailing list! Simply fill out this form to be added to our mailing list and receive information about all of our amazing programs!</b></font></p> <p><font size="+2"></font></p> <form method="post" action="/cgi-bin/mailform?hillelmail"> <font size="+2">Name<br> <input type="text" name="name" size="60"></font> <p><font size="+2">Street<br> <input type="text" name="street" size="60"></font></p> <p><font size="+2">Apartment #<br> <input type="text" name="aptno" size="60"></font></p> <p><font size="+2">City, State and ZIP<br> <input type="text" name="city" size="60"></font></p> <p><font size="+2">Home phone<br> <input type="text" name="homephone" size="60"></font></p> <p><font size="+2">Work phone<br> <input type="text" name="workphone" size="60"></font></p> <p><font size="+2">E-mail<br> <input type="text" name="email" size="60"></font></p> <p><font size="+2">Date of Birth<br> <input type="text" name="dateofbirth" size="60"></font></p> <p><font size="+2">Occupation<br> <input type="text" name="occupation" size="60"></font></p> <p><font size="+2">University attended/attending<br> <input type="text" name="university" size="60"></font></p> <p><font size="+2">Major<br> <input type="text" name="major" size="60"></font></p> <p><font size="+2">Year of Graduation/anticipated graduation<br> <input type="text" name="yeargraduate" size="60"></font></p> <p><font size="+2">Are you currently enrolled<br> <input type="radio" name="current" value="currently enrolled: Yes"> Yes<br> <input type="radio" name="current" value="currently enrolled: NO"> No</font></p> <p><font size="+2">Interests (please mark all that apply)<br> <input type="radio" name="interest1" value="Social">Social<br> <input type="radio" name="interest2" value="Sports">Sports<br> <input type="radio" name="interest3" value="Speakers">Speakers<br> <input type="radio" name="interest4" value="Israel">Israel<br> <input type="radio" name="interest5" value="Jewish Awareness">Jewish Awareness<br> <input type="radio" name="interest6" value="On campus programs">On campus programs (specify campus) <input type="text" name="specify" size="30"><br> <input type="radio" name="interest7" value="United Jewish Appeal">United Jewish Appeal<br> <input type="radio" name="interest8" value="Shabbat Dinners">Shabbat Dinners<br> <input type="radio" name="interest9" value="Community Service">Community Service<br> Other <input type="text" name="otherinterest" size="60"></font></p> <p><font size="+2">Comments, suggestions, or names/addresses of friends:<br> <textarea wrap="VIRTUAL" rows="6" cols="45" name="hillelcomments"></textarea></font></p> <p><font size="+2"><input type="submit" value="Send To HILLEL"> <input type="reset" value="Redo"></font></p> <p><font size="+2"></font></p> </form> <p><font size="+2"><font size="+2" color="#FF0099">Thanks!</font></font></p> <p><font size="+2"> <script language="JavaScript"> var isadmin = 0 ; <CENTER><FONT SIZE=2><B><A HREF="frame.html" TARGET="_top">About HMD</A> | <A HREF="frame2.shtml" TARGET="_top">Community Programs</A> | <A HREF="frame3.html" TARGET="_top">On Campus</A> | <A HREF="emu.html" TARGET="_top">About EMU Hillel</A> | <A HREF="frame4.html" TARGET="_top">Council & Committees</A> | <A HREF="frame5.html" TARGET="_top">Join Our Mailing List</A> | <A HREF="hmdbb.shtml" TARGET="_top">Bulletin Board</A> | Ask Rabbi Cyberstein | <A HREF="frame6.html" TARGET="_top">Links</A> | <A HREF="start.html" TARGET="_top">Home</A></B></FONT></CENTER> </script></font></p> <table> <tr> <td> © 1997 Hillel of Metro Detroit<br> 667 Grosberg Center<br> Wayne State University<br> Detroit, Michigan 48202 <p>phone: 313-577-3459<br> hotline:313-577-8888<br> fax: 313-577-3461<br> email:</p> <p>Site Credit: USWeb Corporation</p> </td> <td><img src="funky.gif"></td> </tr> </table> <p><font size="+2"></font></p> </body>