Respondent-Associate Form

REGION 5 ASSOCIATE PRODUCTION RESPONSE

<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> </head> <background="/background.gif" " text="#000000"><body bgcolor="#ca6514" text="#FFFFFF" link="#FFFFFF" vlink="#FFFFFF" alink="#FFFFFF"> <div align="center"><font face="Myriad Roman"> <script language="JavaScript"> function validateForm(theForm){ if (theForm._fid_46.value == "") { alert("Please enter a value for the \"RespEmail\" field."); theForm._fid_46.focus(); return (false); } return (true); } /********************************************************************* CheckForOther Handles the Other selection from a SELECT object */ function CheckForOther (item, origlen) { var sitem = item.options[item.selectedIndex]; if (item.selectedIndex == (item.length - 1)) { var val = prompt ("ADD A NEW CHOICE:", ""); if (val == null) item.selectedIndex = 0; else { var slen = item.length; if (slen == origlen+1){ item.options[slen] = new Option (sitem.text, sitem.value); } item.options[item.length-2].text = val; item.options[item.length-2].value = val; item.selectedIndex = item.length-2; } } } </script> </font> <font color="#0000FF" face="Myriad Roman" size="+2"><b><font color="#FFFFFF" size="+5" face="Arial, Helvetica, sans-serif">KCACTF Region V</font></b></font> </div> <h2 align="center"><font color="#FFFFFF" face="Arial, Helvetica, sans-serif" size="+3">Associate Entry Response Form</font></h2> <form name="qdbform" method="POST" onsubmit="return validateForm(this)" enctype="multipart/form-data" action="https://kcactf.quickbase.com/db/8t57stnn?act=API_AddRecord"> <font face="Myriad Roman"> <input type="hidden" name="fform" value="1" /> <input type="hidden" name="rdr" value="http://www.kcactf5.org/Respondents/Associate/ASSOCResponsesuccess.html" /> </font> <table> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"> <div align="right"><font color="#000000" face="Arial, Helvetica, sans-serif">Respondent's First Name:</font> </div></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif"> <input type="text" name="_fid_6" size="50" /> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right"> <div align="right"><font color="#000000">Respondent's Last Name</font>e </div></td> <td class="m"><font color="#000000" face="Arial, Helvetica, sans-serif"> <input name="_fid_49" type="text" id="_fid_49" size="50" /> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Respondent's University/College:</font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif"> <input type="text" name="_fid_7" size="50" /> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Name of Production Seen:</font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif"> <input type="text" name="_fid_8" size="50" /> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Produced by which University/College?</font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif"> <input type="text" name="_fid_9" size="50" /> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Date Seen:</font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif"> <input type="text" name="_fid_10" size="25" /> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Playwright: </font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif"> Name: <input type="text" name="_fid_15" size="40" /> Status: <select name="_fid_14" size="1"> <option></option> <option value="Other">Other</option> <option value="Student">Student</option> <option value="Faculty">Faculty</option> </select> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Director:</font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif">Name: <input type="text" name="_fid_17" size="40" /> Status: <select name="_fid_16" size="1"> <option></option> <option value="Faculty">Faculty</option> <option value="Student">Student</option> <option value="Guest Director">Guest Director</option> <option value="Other">Other</option> </select> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Scenic Designer: </font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif"> Name: <input type="text" name="_fid_19" size="40" /> Status: <select name="_fid_18" size="1"> <option></option> <option value="Faculty">Faculty</option> <option value="Student">Student</option> <option value="Other">Other</option> </select> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Costume Designer: </font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif">Name: <input type="text" name="_fid_21" size="40" /> Status: <select name="_fid_20" size="1"> <option></option> <option value="Faculty">Faculty</option> <option value="Student">Student</option> <option value="Other">Other</option> </select> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Make-up Designer: </font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif">Name: <input type="text" name="_fid_23" size="40" /> Status: <select name="_fid_22" size="1"> <option></option> <option value="Faculty">Faculty</option> <option value="Student">Student</option> <option value="Other">Other</option> </select> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Lighting Designer:</font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif">Name: <input type="text" name="_fid_25" size="40" /> Status: <select name="_fid_24" size="1"> <option></option> <option value="Faculty">Faculty</option> <option value="Student">Student</option> <option value="Other">Other</option> </select> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">Sound Designer: </font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif">Name: <input type="text" name="_fid_27" size="40" /> Status: <select name="_fid_26" size="1"> <option></option> <option value="Faculty">Faculty</option> <option value="Student">Student</option> <option value="Other">Other</option> </select> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif"><b>YOUR</b> Irene Ryan Scholarship Nominee:</font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif"> <input type="text" name="_fid_28" size="50" /> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" face="Arial, Helvetica, sans-serif">The <b>Director's</b> Irene Ryan Scholarship Nominee:</font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif"> <input type="text" name="_fid_29" size="50" /> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" colspan="2"> <div align="left"> <p><font color="#000000" face="Arial, Helvetica, sans-serif">Was the KCACTF Sponsorship Information included in this production's program?</font> <font color="#000000" face="Arial, Helvetica, sans-serif"> <select name="_fid_48" size="1"> <option value="Choose one...">Choose one...</option> <option value="YES">YES</option> <option value="NO">NO</option> <option value="DON'T KNOW">DON'T KNOW</option> </select> </font></p> </div> </td> </tr> <tr bgcolor="#F0F0F0" valign="middle" align="left"> <td class="m" colspan="2"> <p align="left"><font color="#000000" face="Arial, Helvetica, sans-serif">Is there any additional information about this production you would like to share with the Regional Chair? This information is confidential and will not be shared with the producing school.This field might be used for explanations, venting, words of wisdom...</font></p> <div align="center"></div> <ul> </ul> <font color="#000000" face="Arial, Helvetica, sans-serif"> <textarea wrap="virtual" name="_fid_45" rows="10" cols="100">Replace this text with your written report... </textarea> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right" width="137"><font color="#000000" size="+1" face="Arial, Helvetica, sans-serif">* </font><font color="#000000" face="Arial, Helvetica, sans-serif">Respondent's Email Address (this required field will serve as your electronic signature):</font></td> <td class="m" width="512"> <font color="#000000" face="Arial, Helvetica, sans-serif"> <input type="text" size="40" name="_fid_46" /> </font></td> </tr> <tr bgcolor="#F0F0F0" valign="middle"> <td class="m" align="right"> </td> <td class="m"><font color="#000000" face="Arial, Helvetica, sans-serif">Would you like a copy of this response emailed to you? Check here if YES: </font><font color="#0000FF" face="Arial, Helvetica, sans-serif"> <input type="checkbox" name="_fid_51" value="YES"> </font></td> </tr> </table> <p><font color="#ca6514" face="Arial, Helvetica, sans-serif">Note: after you hit the "Submit Response" button below, you should receive a "Thanks for your response" message. If you DON'T, please contact Rick Anderson at<a href="mailto:rickanderson@kcactf5.org"> rickanderson@kcactf5.org</a></font></p> <p><font face="Myriad Roman"> <input type="submit" value="Submit your Response" /> </font> </p> </form> <br /> </html> </div> </div> <div><div id="351918482604659276" align="left" style="width: 100%; overflow-y: hidden;" class="wcustomhtml"><title>KCACTF Region V Associate Response Form

Respondent's First Name:
Respondent's Last Name
Respondent's University/College:
Name of Production Seen:
Produced by which University/College?
Date Seen:
Playwright:	Name: Status:
Director:	Name: Status:
Scenic Designer:	Name: Status:
Costume Designer:	Name: Status:
Make-up Designer:	Name: Status:
Lighting Designer:	Name: Status:
Sound Designer:	Name: Status:
YOUR Irene Ryan Scholarship Nominee:
The Director's Irene Ryan Scholarship Nominee:
Was the KCACTF Sponsorship Information included in this production's program?
Is there any additional information about this production you would like to share with the Regional Chair? This information is confidential and will not be shared with the producing school.This field might be used for explanations, venting, words of wisdom... Replace this text with your written report...
* Respondent's Email Address (this required field will serve as your electronic signature):
	Would you like a copy of this response emailed to you? Check here if YES:

Note: If you have checked YES, then after you hit the "Submit Response" button below, you should receive a "Thanks for your response" message. If you DON'T receive it within 30 minutes, please contact Jim Wood at [email protected]