CRCTVN Member Registration

In order for us to effectively coordinate your participation and
contribution, we need some  general information from you.
Please take a moment to fill out the following form.

We respect your personal information, and we ensure that your
information will only be used by the administration team in
coordinating tasks for CRCTVN members.


Full Name: ______________________________________________________
(e.g. Nguye^~n Minh Hoa`ng)

Address (optional):______________________________________________

City: ___________________________________________________________

State/Province (optional): ______________________________________

Country: ________________________________________________________

Email: __________________________________________________________

Phone (optional):________________________________________________

Year of Birth (optional): _______________________________________

Occupation (optional): __________________________________________

Your strength/skill (optional): _________________________________
(e.g. "Legal" or "C++, VB, Web development" or "Writing" or etc.)
_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

Comments or Suggestions (optional): _____________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________


Please select the team(s) you like to join:
  . Public Relation _____
  . Administration  _____
  . Technical/Web   _____
  . Content         _____


Are you planning to attend our CRCTVN Conference 2003
(Summer of 2003) in Vancouver?

_____


Would you like to become an active member of the CRCTVN organization?

_____


We will update our web site and proudly list all team members with
member name, city and country (e.g. Nguye^~n Chi' Huy, Toronto, Canada).
Would you like your name to be listed on CRCTVN web site, under the
Member section?

_____


Please email the filled form to admin@crctvn.com.

Thank you for time and consideration.