To join PAN FORUM PLACES, you can fill out this form. You will receive information on the next meetings to join the PAN FORUM network (for a physical meeting and an exchange with the other places).

<form>
action mail dom@dominiqueleroy.info
Thanks "WELCOME & THANK YOU FOR YOUR CONTRIBUTION !"

Fieldset "PLACE INFORMATION: :"
Textbox  "PLACE NAME:" 
textarea "PLACE PRESENTATION :" !
static "You can present your place in few lines"
Textbox  "REFERANT NAME:" 
email "E-MAIL:"
textbox "PHONE: (optionel)" !
textbox "WEBSITE: (optionel)" !

yesno "I autorize the network to communicate my contacts"

static "This register is accessible for network members only"

 

textarea "PLACE RESOURCES :" !

textarea "PLACE NEEDS :" !
static  "* Here you can indicate regular services the place can offer to people and other places (as resources & needs). Your list and contact will be updated and published in the register every month"

textarea "PLACE ANNOUNCEMENT :" !
static "* A one-off needs or resource that you communicate to people and places (ex: donation of furniture, repair week...). Do not forget to indicate practical information, such as the date and place ... This announcement will be updated and published every month in the register." 

submit "SEND"
</form>