Above and Beyond - The Charitable Trusts for the United Bristol Hospitals : Valentine's Day Registration/title> <meta http-equiv="Content-Language" content="en-gb"> <meta http-equiv="Content-Style-Type" content="text/css"> <meta content="About The Charitable Trusts for the United Bristol Hospitals" name="description" > <meta content="charity, trust, hospitals, hospital, Bristol, donations, donor, fundraising, medical, appeals, activities, bursaries, awards, funding, education, research, UBHT, support, charitable trust, charity trustee, current appeal, money raising, online donations, fundraising activities, children’s hospital, Bristol Royal Infirmary, specialist equipment" name="Keywords" /> <meta content="The Charitable Trusts for the United Bristol Hospitals" name="author" > <meta content="The Charitable Trusts for the United Bristol Hospitals, The Abbot's House, Blackfriars, Bristol, Avon, BS1 2NZ, UK. Website http://www.aboveandbeyond.org.uk E-mail mailto:info@aboveandbeyond.org.uk, Telephone 0117 927 7120" name="DC.publisher" > <meta content="Copyright © The Charitable Trusts for the United Bristol Hospitals, http://www.aboveandbeyond.org.uk/about_ctubh.aspx" name="DC.rights.copyright" > <script language="JavaScript" src="jscript/rollover.js" type="text/javascript"></script> <link rel="stylesheet" type="text/css" href="css/abovebeyondprint.css" media="print"> <link rel="stylesheet" type="text/css" href="css/abovebeyond.css" media="screen"> <link rel="stylesheet" type="text/css" href="css/abovebeyondhandheld.css" media="handheld"> </head> <body style="background-color:#e33536" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0"> <a id="top" name="top"></a> <div id="outercontainer"> <div id="maincontainer"><div id="header2"> <table width="800" cellpadding="0" cellspacing="0" summary="Layout"> <tr> <td valign="top"><img src="images/spacer.gif" width="350" height="90" alt="Above & Beyond" /></td> <td valign="top"> <img style="float:right; margin-right:6px" src="images/above_and_beyond_logo.gif" width="264" height="72" alt="Above & Beyond Charities" /></td> </tr> </table> </div> <div id="printheader"><img src="images/print_logo.gif" alt="Above & Beyond" /><div class="donatefullink">Donate online at: www.justgiving.com/aboveandbeyond</div></div> <div class="clear"></div> <div id="headnavinner"> <div id="abtopnav"> <div id="topnavlinks"> <ul class="navtop"> <li class="home"><a href="index.aspx" title="Home page of the site"><span>Home</span></a> </li> <li class="about"><a href="about_above_and_beyond.aspx" title="About Us section"><span>About Us</span></a> </li> <li class="news"><a href="ctubh_news.aspx" title="Visit our news section"><span>News</span></a> </li> <li class="events"><a href="ctubh_fundraising_events_calendar.aspx" title="Visit our latest and past events section"><span>Events</span></a> </li> <li class="support"><a href="helping_us.aspx" title="Read about how you can support us"><span>Support Us</span></a> </li> <li class="hob"><a href="appeal_intro.aspx" title="Read about the Heart of Bristol appeal we are supporting"><span>Heart of Bristol Appeal</span></a></li> <li class="info"><a href="resources.aspx" title="Read more information for fund advisors"><span>Information for Fund Advisors</span></a></li> <li class="contact"><a href="contact_us.aspx" title="View ways of getting in touch with us"><span>Contact Us</span></a></li> </ul> </div> </div> <div class="redstrap"><img src="images/redstrap.gif" width="792" height="11" alt="" /></div> <div id="everyclickinner"> <form target="_blank" action="http://www.everyclick.com/aboveandbeyondcharities/search" method="get" title="Opens a search in a new window"><div style="width:100%;height:23px;margin-bottom:0px;padding-bottom:0px"> <span style="float:left; margin:0 0 0 52px;"><input name="keyword" id="keyword" type="text" style="font-family: Arial, Helvetica, sans-serif; font-size: 12px;font-weight:normal; height:18px;color:#000000; border:1px solid #CAEDFF;background-color:#FFFFFF;" size="16" value="Search the web" onfocus="this.value=''" /></span> <input name="refresh" type="image" title="Search the web" alt="Search the web" value="Submit" src="images/everyclick_search.jpg" style="margin:2px 0 0 5px; float:left;" /><span class="alwayshide"><label for="keyword">Search</label></span> <br /> </div></form> </div> </div>  <div id="handheldnav"> <hr /> <a href="about_above_and_beyond.aspx" title="View an introduction"> Introduction</a> • <a href="appeal_bristol_heart_institute.aspx" title="View the new Bristol heart institute">The new Bristol Heart Institute</a> • <a href="appeal_projects_supported.aspx" title="View projects that we are supporting"> Projects we're supporting</a> • <a href="appeal_arts_programme.aspx" title="View the arts programme"> Arts Programme</a> • <a href="appeal_get_involved.aspx" title="See how to get involved"> Get Involved</a> • <a href="appeal_valentines_day.aspx" title="View our Valentines day challenge">Valentine's Day Challenge</a> • <a href="appeal_valentines_day_get_involved.aspx" title="Get involved with the vaneltines day challenge"> Get Involved!</a> • <a href="appeal_valentines_day_registration.aspx" title="View valentines day challenge registration form"> Registration</a> • <a href="appeal_valentines_day_buy_pin_badge.aspx" title="Buy a valentines day challenge pin badge"> Buy your Pin Badge </a> • <hr /> </div> <div id="strap"> <h1>Above and Beyond - The Charitable Trust for the United Bristol Hospitals</h1> </div> <table border="0" cellpadding="0" cellspacing="0" class="layouttab" summary="Layout"> <tr> <td class="nav"> <div id="leftnav"> <div id="leftnavli"><ul> <li><a href="appeal_intro.aspx" title="View the appeal introductory page"> Introduction</a></li> <li class="bottomlineappeal"><a href="appeal_bristol_heart_institute.aspx" title="Information about the news Bristol Heart Insititute">The new Bristol<br /> Heart Institute</a></li> <li><a href="appeal_projects_supported.aspx" title="Projects that we are supporting"> Projects we're supporting</a></li> <li><a href="appeal_arts_programme.aspx" title="See our arts programme"> Arts Programme</a></li> <li><a href="appeal_get_involved.aspx" title="Get involved with Above and Beyond"> Get Involved</a></li> <li class="bottomlineappeal"><a href="appeal_valentines_day.aspx" title="Valentines day challenge - more info">Valentine's Day<br /> Challenge</a></li> <li class="nobullet"><a href="appeal_valentines_day_get_involved.aspx" title="Get involved with helping us at Above and Beyond - valentines day appeal"> - Get Involved!</a></li> <li class="nobullet"><a href="appeal_valentines_day_registration.aspx" title="Register with the valentines day appeal"> - Registration</a></li> <li class="nobullet"><a href="appeal_valentines_day_buy_pin_badge.aspx" title="Purchase your pin badge"> - Buy your Pin Badge </a></li> </ul> <img src="images/ANB_inner12_20.gif" alt="" /></div> </div> </td> <td class="main"> <div id="mainbody"> <a id="sectop" name="sectop"></a> <div id="heartofbristol"><img src="images/ANB_hob_logo_small.gif" alt="The Heart of Bristol Appeal Logo" width="162" height="75"></div> <div id="headingheart"> <h2>Registration</h2> <img src="images/t_appeal_valentines_registr.gif" alt="Registration" width="513" height="40"></div>  <p> <div id="panelSendEmail">  <form name="ctl06" method="post" action="appeal_valentines_day_registration.aspx" id="ctl06"> <input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="/wEPDwULLTE5MDgyODYwMjhkGAEFHl9fQ29udHJvbHNSZXF1aXJlUG9zdEJhY2tLZXlfXxYCBRJsaWtlVG9TZWxsQ2hlY2tCb3gFFmNhbkhlbHBQcm9tb3RlQ2hlY2tCb3jt0iS8jjvl1ewOyB6XmhaVhBTXiw==" /> <div class="pagetext"><p>To get involved and receive your <span class="valentine"> FREE </span>fundraising pack please just complete the form below!</p> <p>Please complete all sections marked with *. The other sections are optional.</p> </div> <br /> <table class="formlabels" width="50%" align="center" summary="Layout"> <tbody> <tr> <td width="15%"> <span id="nameLabel"><label for="nameTextBox">Name: </label>*</span></td> <td width="25%"> <input name="nameTextBox" type="text" maxlength="150" id="nameTextBox" /> </td> </tr> <tr> <td width="15%"></td> <td valign="top" width="25%"> </td> </tr> <tr> <td width="15%"> <span id="orgLabel"><label for="orgTextBox">Organisation:</label></span></td> <td width="25%"> <input name="orgTextBox" type="text" maxlength="200" id="orgTextBox" /> </td> </tr> <tr> <td width="15%"> <span id="emailAddLabel"><label for="emailAddTextBox">Your email address</label>: *</span></td> <td width="25%"> <input name="emailAddTextBox" type="text" maxlength="200" id="emailAddTextBox" /> </td> </tr> <tr> <td width="15%"></td> <td valign="top" width="25%"> <br /> </td> </tr> <tr> <td valign="top" width="15%"> <span id="addLabel"><label for="addTextBox">Address</label>:</span></td> <td width="25%"> <textarea name="addTextBox" rows="4" cols="40" id="addTextBox"></textarea> </td> </tr> <tr> <td width="15%"> <span id="postcodeLabel"><label for="postcodeTextBox">Postcode</label>:</span></td> <td width="25%"> <input name="postcodeTextBox" type="text" maxlength="200" id="postcodeTextBox" /> </td> </tr> <tr> <td width="15%"> <span id="telephoneLabel"><label for="telephoneTextBox">Telephone</label>:</span></td> <td width="25%"> <input name="telephoneTextBox" type="text" maxlength="200" id="telephoneTextBox" /> </td> </tr> <tr><td colspan="2"> </td></tr> <tr> <td><input id="likeToSellCheckBox" type="checkbox" name="likeToSellCheckBox" /></td> <td> <span id="likeToSellLabel"><label for="likeToSellCheckBox">Tick the box on the left if you would like to sell our limited edition 'Bristol Hearts' pin badges (They come in display boxes of 50 pin badges) </label></span></td> </tr> <tr> <td><input id="canHelpPromoteCheckBox" type="checkbox" name="canHelpPromoteCheckBox" /></td> <td> <span id="canHelpPromoteLabel"><label for="canHelpPromoteCheckBox">Tick the box on the left if you can help promote the Valentine's Day Challenge via a link on your website or by email </label></span></td> </tr> <tr><td colspan="2"> </td></tr> <tr> <td> </td><td> <span id="howHearLabel"><label for="howHearTextBox">How did you hear about the Valentine's Day Challenge?</label>: *</span><br /> <input name="howHearTextBox" type="text" maxlength="200" id="howHearTextBox" /> </td> </tr> <tr><td colspan="2"> </td></tr> <tr> <td valign="top" width="15%"> <span id="messageLabel"><label for="messageTextBox">Other<br />Comments</label>: </span></td> <td width="25%"> <textarea name="messageTextBox" rows="4" cols="40" id="messageTextBox"></textarea> </td> </tr> <tr> <td width="15%"></td> <td width="25%"> <br /> <input type="submit" name="sendMessageButton" value="Send message" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("sendMessageButton", "", true, "", "", false, false))" id="sendMessageButton" title="click here to send your message" /> </td> </tr> </tbody> </table>  <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION" value="/wEWDALPwpK6BAKLsYSOBwKw29fhCAL3z/noCAKq4qPqCALHtdrzDQLQx6P4CwKJw5zZCQLZ/czoDQKthOyBBgKqp5K5DgKyiMmRBC5D2mVVO8CdPXo3AV0AAAtfgeVH" /></form> </div> <div class="backtotop-button"><a href="#top"><img src="images/backtotop.jpg" alt="Back to top >>" width="115" height="12" /></a></div></div> <div id="original"><div id="originalinner"> <a href="http://www.originalbristol.com" target="_blank" title="Opens a new window"><img src="images/original_bristol_logo.gif" alt="In association with Original Bristol 106.5"></a></div> </div> </td> </tr> </table> <div id="footerindex"> <div class="purplebar"></div> <div class="footerbar"> <div class="footlinks"><a href="terms_conditions.aspx">Terms</a><span class="navdiv"> | </span><a href="sitemap.aspx">Site Map</a><span class="navdiv"> | </span><a href="http://www.gwsmedia.com/" target="_blank" title="GWS Media - Opens in a new window">Design</a> </div> <div class="footcopyright">© 2008 Above & Beyond </div> Telephone: 0117 927 7120</div> <div class="uhb"><a href="http://www.uhbristol.nhs.uk" target="_blank" title="Opens a new window"><img src="images/foot_logos.gif" alt="University Hospitals Bristol" width="270" height="25" border="0" usemap="#Map" /> <map name="Map" id="Map"> <area shape="rect" coords="0,3,144,24" href="http://www.uhbristol.nhs.uk" target="_blank" alt="University Hospitals Bristol NHS Foundation Trust" title="Opens in a new window" /> <area shape="rect" coords="144,3,217,23" href="http://www.bristolpct.nhs.uk" target="_blank" alt="Bristol Primary Care Trust" title="Opens in a new window" /> <area shape="rect" coords="217,1,267,22" href="http://www.northsomerset.nhs.uk" target="_blank" alt="North Somerset Primary Care Trust" title="Opens in a new window" /> </map></a></div> <div class="footersmalltext-index">Above & Beyond Charities is the working name for the Charitable Trusts for the United Bristol Hospitals<br /> Supporting University Hospitals Bristol NHS Foundation Trust & the Bristol and North Somerset Primary Care Trusts.</div> </div> <script type="text/javascript"> var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); </script> <script type="text/javascript"> var pageTracker = _gat._getTracker("UA-5722921-1"); pageTracker._trackPageview(); </script> </div> </div> </body> </html>