<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <html> <head><title>ASL Teaching Services Form</title> <meta http-equiv="Content-Type" content="text/html; charset=unicode"> <script> /* Submit Once form validation- ) Dynamic Drive (www.dynamicdrive.com) For full source code, usage terms, and 100's more DHTML scripts, visit http://dynamicdrive.com */ function submitonce(theform){ //if IE 4+ or NS 6+ if (document.all||document.getElementById){ //screen thru every element in the form, and hunt down "submit" and "reset" for (i=0;i<theform.length;i++){ var tempobj= theform.elements[i]if(tempobj.type.toLowerCase()=="submit"||tempobj.type.toLowerCase()=="reset") //disable em tempobj.disabled=true } } } </script> <style type="text/css"> <!-- body,td { font-family: verdana, helvetica; font-size: 11px; color: #555555; } input.search { font-size: 9px; padding: 0px; margin: 0px; margin-top: 3px; } A:link { text-decoration: none; } A:visited { text-decoration: none; } A:hover { text-decoration: underline; } A.foot { color: #ffffff; } .carea { line-height: 16px; } .foot { font-size: 9px; } .style1 {font-size: 14px} .style10 { border-left-color: #666666; border-left-width: 0px; border-right-color: #666666; border-right-width: 0px; border-top-color: #666666; border-top-width: 0px; border-bottom: 1px solid #666666; background-color: #ffffff; } .style11 { text-align: center; } .style12 { text-align: center; border-left-style: solid; border-left-color: #FFFFFF; border-right-style: solid; border-right-color: #FFFFFF; border-top: 1px solid #FFFFFF; border-bottom-style: solid; border-bottom-color: #FFFFFF; background-color: #FFFFFF; } .style13 { text-align: center; border-style: solid; border-width: 1px; } .style14 { text-align: center; border-style: solid; border-width: 0; } .style15 { font-size: medium; } .style16 { font-size: small; } --> </style> <meta content="MSHTML 6.00.6000.16481" name="GENERATOR"> </head> <body> <p align="center">ASL Teaching Services<br> FALL 2010&nbsp; <table align="center" cellpadding="2" class="style10" style="width: 800"> <tr> <td class="style14" colspan="7">SATURDAY</td> </tr> <tr> <td class="style13" style="width: 91px">Course Number</td> <td class="style13" style="width: 91px">Course Name</td> <td class="style13" style="width: 132px">Time</td> <td class="style13" style="width: 62px">Hours</td> <td class="style13" style="width: 134px">Start Date</td> <td class="style13">End Date</td> <td class="style13">Cost</td> </tr> <tr> <td class="style13" style="width: 91px">1</td> <td class="style13" style="width: 91px">ASL101</td> <td class="style13" style="width: 132px">9:00 AM - 1:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 11, 2010</td> <td class="style13">Nov 20, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">2</td> <td class="style13" style="width: 91px">ASL102</td> <td class="style13" style="width: 132px">9:00 AM - 1:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 11, 2010</td> <td class="style13">Nov 20, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">3</td> <td class="style13" style="width: 91px">ASL103</td> <td class="style13" style="width: 132px">9:00 AM - 1:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 11, 2010</td> <td class="style13">Nov 20, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">4</td> <td class="style13" style="width: 91px">ASL201</td> <td class="style13" style="width: 132px">9:00 AM - 1:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 11, 2010</td> <td class="style13">Nov 20, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">5</td> <td class="style13" style="width: 91px">ASL203</td> <td class="style13" style="width: 132px">9:00 AM - 1:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 11, 2010</td> <td class="style13">Nov 20, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style12" style="width: 91px">&nbsp;</td> <td class="style12" style="width: 91px">&nbsp;</td> <td class="style12" style="width: 132px">&nbsp;</td> <td class="style12" style="width: 62px">&nbsp;</td> <td class="style12" style="width: 134px">&nbsp;</td> <td class="style12">&nbsp;</td> <td class="style12">&nbsp;</td> </tr> <tr> <td class="style11" colspan="7">MONDAYS &amp; WEDNESDAY</td> </tr> <tr> <td class="style13" style="width: 91px">Course Number</td> <td class="style13" style="width: 91px">Course Name</td> <td class="style13" style="width: 132px">Time</td> <td class="style13" style="width: 62px">Hours</td> <td class="style13" style="width: 134px">Start Date</td> <td class="style13">End Date</td> <td class="style13">Cost</td> </tr> <tr> <td class="style13" style="width: 91px">6</td> <td class="style13" style="width: 91px">ASL101</td> <td class="style13" style="width: 132px">7:00 PM - 9:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 13, 2010</td> <td class="style13">Nov 22, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px; height: 20px;">7</td> <td class="style13" style="width: 91px; height: 20px;">ASL201</td> <td class="style13" style="width: 132px; height: 20px;">5:00 PM - 7:00 PM</td> <td class="style13" style="width: 62px; height: 20px;">40</td> <td class="style13" style="width: 134px; height: 20px;">Sep 13, 2010</td> <td class="style13" style="height: 20px">Nov 22, 2010</td> <td class="style13" style="height: 20px">$260.00</td> </tr> <tr> <td class="style11" style="width: 91px">&nbsp;</td> <td class="style11" style="width: 91px">&nbsp;</td> <td class="style11" style="width: 132px">&nbsp;</td> <td class="style11" style="width: 62px">&nbsp;</td> <td class="style11" style="width: 134px">&nbsp;</td> <td class="style11">&nbsp;</td> <td class="style11">&nbsp;</td> </tr> <tr> <td class="style11" colspan="7">TUESDAY</td> </tr> <tr> <td class="style13" style="width: 91px">Course Number</td> <td class="style13" style="width: 91px">Course Name</td> <td class="style13" style="width: 132px">Time</td> <td class="style13" style="width: 62px">Hours</td> <td class="style13" style="width: 134px">Start Date</td> <td class="style13">End Date</td> <td class="style13">Cost</td> </tr> <tr> <td class="style13" style="width: 91px; height: 20px;">8</td> <td class="style13" style="width: 91px; height: 20px;">ASL101</td> <td class="style13" style="width: 132px; height: 20px;">9:00 AM - 1:00 PM</td> <td class="style13" style="width: 62px; height: 20px;">40</td> <td class="style13" style="width: 134px; height: 20px;">Sep 14, 2010</td> <td class="style13" style="height: 20px">Nov 16, 2010</td> <td class="style13" style="height: 20px">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">9</td> <td class="style13" style="width: 91px">ASL102</td> <td class="style13" style="width: 132px">9:00 AM - 1:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 14, 2010</td> <td class="style13">Nov 16, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">10</td> <td class="style13" style="width: 91px">ASL103</td> <td class="style13" style="width: 132px">9:00 AM - 1:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 14, 2010</td> <td class="style13">Nov 16, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style11" style="width: 91px">&nbsp;</td> <td class="style11" style="width: 91px">&nbsp;</td> <td class="style11" style="width: 132px">&nbsp;</td> <td class="style11" style="width: 62px">&nbsp;</td> <td class="style11" style="width: 134px">&nbsp;</td> <td class="style11">&nbsp;</td> <td class="style11">&nbsp;</td> </tr> <tr> <td class="style11" colspan="7">TUESDAYS &amp; THURSDAYS</td> </tr> <tr> <td class="style13" style="width: 91px">Course Number</td> <td class="style13" style="width: 91px">Course Name</td> <td class="style13" style="width: 132px">Time</td> <td class="style13" style="width: 62px">Hours</td> <td class="style13" style="width: 134px">Start Date</td> <td class="style13">End Date</td> <td class="style13">Cost</td> </tr> <tr> <td class="style13" style="width: 91px">11</td> <td class="style13" style="width: 91px">ASL101</td> <td class="style13" style="width: 132px">5:00 PM - 7:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 14, 2010</td> <td class="style13">Nov 18, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">12</td> <td class="style13" style="width: 91px">ASL102</td> <td class="style13" style="width: 132px">7:00 PM - 9:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 14, 2010</td> <td class="style13">Nov 18, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">13</td> <td class="style13" style="width: 91px">ASL201</td> <td class="style13" style="width: 132px">7:00 PM - 9:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 14, 2010</td> <td class="style13">Nov 18, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">14</td> <td class="style13" style="width: 91px">ASL202</td> <td class="style13" style="width: 132px">5:00 PM - 7:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 14, 2010</td> <td class="style13">Nov 18, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">15</td> <td class="style13" style="width: 91px">ASL203</td> <td class="style13" style="width: 132px">7:00 PM - 9:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 14, 2010</td> <td class="style13">Nov 18, 2010</td> <td class="style13">$260.00</td> </tr> <tr> <td class="style13" style="width: 91px">16</td> <td class="style13" style="width: 91px">Fingerspelling</td> <td class="style13" style="width: 132px">6:00 PM - 7:00 PM</td> <td class="style13" style="width: 62px">40</td> <td class="style13" style="width: 134px">Sep 14, 2010</td> <td class="style13">Nov 18, 2010</td> <td class="style13">$155.00</td> </tr> <tr> <td class="style11" style="width: 91px">&nbsp;</td> <td class="style11" style="width: 91px">&nbsp;</td> <td class="style11" style="width: 132px">&nbsp;</td> <td class="style11" style="width: 62px">&nbsp;</td> <td class="style11" style="width: 134px">&nbsp;</td> <td class="style11">&nbsp;</td> <td class="style11">&nbsp;</td> </tr> </table> <p align="center" class="style1">PLEASE FORWARD CHEQUE OR MONEY ORDER TO ASL TEACHING SERVICES <h5 align="center"> <div align="center"><span class="style15">$25.00 FEE EITHER ANY RETURNED CHEQUE OR AFTER SECOND CLASS&nbsp;</span> <p class="style16">For ASL 102 &amp; up, please bring your certificate or transcript on the first day of the class.</p></div> <form action="/mailer/mailer.php" method="post" name="form1" onSubmit="submitonce(this)"> <table width="535" border="0" cellspacing="1" cellpadding="1" align="center"> <tr> <td width="167"> <p align="right"><strong>First Name:</strong></p></td> <td width="361"> <input name="FName" size="30" > </td> </tr> <tr> <td><div align="right"><strong>Last Name:</strong></div></td> <td><input name="LName" size="30" ></td> </tr> <tr> <td> <p align="right"><strong>Address:</strong><br> </p></td> <td> <input name="Address" id="Address" size="30" > </td> </tr> <tr> <td><div align="right"><strong>City/Town:</strong></div></td> <td><input name="City" id="City" size="30" ></td> </tr> <tr> <td><div align="right"><strong>Province/State:</strong></div></td> <td><input name="Province" id="Province" size="30" ></td> </tr> <tr> <td><div align="right"><strong>Postal/Zip Code:</strong></div></td> <td><input name="Postal" id="Postal" size="30" ></td> </tr> <tr> <td> <p align="right"><strong>Home Phone:</strong></p> </td> <td> <p>( <input name="HAC" id="HAC" size="3" maxlength="3" > )&nbsp; <input name="HPhone1" id="HPhone1" size="3" maxlength="3" > - <input name="HPhone2" id="HPhone2" size="4" maxlength="4" > </p> </td> </tr> <tr> <td> <p align="right"><strong>Work Phone:</strong></p> </td> <td> <p>( <input name="WAC" id="WAC" size="3" maxlength="3" > )&nbsp; <input name="WPhone1" id="WPhone1" size="3" maxlength="3" > - <input name="WPhone2" id="WPhone2" size="4" maxlength="4" > </p> </td> </tr> <tr> <td> <p align="right"><strong>Fax Phone:</strong></p> </td> <td> <p>( <input name="FAC" id="FAC" size="3" maxlength="3" > )&nbsp; <input name="FPhone1" id="FPhone1" size="3" maxlength="3" > - <input name="FPhone2" id="FPhone2" size="4" maxlength="4" > </p> </td> </tr> <tr> <td><div align="right"><strong>Email Address:</strong></div></td> <td><input name="Email" id="Email" size="30" > <font size="1">Make sure email is correct</font> </td> </tr> <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr> <tr> <td><p align="right"><strong>Course:</strong></p></td> <td><select name="Course" id="Course" size="1"> <option selected="">Select a Course</option> <option> 1 A.S.L. 101 9:00 A.M. - 1:00 P.M. 40 SEPT 11 NOV 20 $260.00 </option> <option> 2 A.S.L. 102 9:00 A.M. - 1:00 P.M. 40 SEPT 11 NOV 20 $260.00 </option> <option> 3 A.S.L. 103 9:00 A.M. - 1:00 P.M. 40 SEPT 11 NOV 20 $260.00 </option> <option> 4 A.S.L. 201 9:00 A.M. - 1:00 P.M. 40 SEPT 11 NOV 20 $260.00 </option> <option> 5 A.S.L. 203 9:00 A.M. - 1:00 P.M. 40 SEPT 11 NOV 20 $260.00 </option> <option> 6 A.S.L. 101 7:00 P.M. - 9:00 P.M. 40 SEPT 13 NOV 22 $260.00 </option> <option> 7 A.S.L. 201 5:00 P.M. - 7:00 P.M. 40 SEPT 13 NOV 22 $260.00 </option> <option> 8 A.S.L. 101 9:00 A.M. - 1:00 P.M. 40 SEPT 14 NOV 16 $260.00 </option> <option> 9 A.S.L. 102 9:00 A.M. - 1:00 P.M. 40 SEPT 14 NOV 16 $260.00 </option> <option> 10 A.S.L. 103 9:00 A.M. - 1:00 P.M. 40 SEPT 14 NOV 16 $260.00 </option> <option> 11 A.S.L. 101 5:00 P.M. - 7:00 P.M. 40 SEPT 14 NOV 18 $260.00 </option> <option> 12 A.S.L. 102 7:00 P.M. - 9:00 P.M. 40 SEPT 14 NOV 18 $260.00 </option> <option> 13 A.S.L. 201 7:00 P.M. - 9:00 P.M. 40 SEPT 14 NOV 18 $260.00 </option> <option> 14 A.S.L. 202 5:00 P.M. - 7:00 P.M. 40 SEPT 14 NOV 18 $260.00 </option> <option> 15 A.S.L. 203 7:00 P.M. - 9:00 P.M. 40 SEPT 14 NOV 18 $260.00 </option> <option> 16 FINERSPELLING 6:00 P.M. - 7:00 P.M. 40 SEPT 14 NOV 18 $155.00 </option> </select></td> </tr> <tr> <td align="right" valign="top"> <p><strong>Additional Information::</strong></p></td> <td><textarea name="Message" rows="5" cols="45"></textarea></td> </tr> <tr> <td colspan="2" align="middle"><input type="submit" value="Send Message">&nbsp;&nbsp;&nbsp;<input type="reset" value="Reset"></td> </tr> </table> </form></h5> </body> </html>