Form <CENTER><FONT FACE="Verdana,Geneva,Arial,Helvetica,sans-serif" SIZE="4"><B>Join the NESEA Network!</B></FONT></CENTER><BR><BR> <FONT FACE="Verdana,Geneva,Arial,Helvetica,sans-serif" SIZE="2">Please fill out the information below and submit the form. You will be added to the NESEA Network email list and will receive periodic action alerts and informational materials. This list will be used solely by NESEA and will not be distributed to other organizations. Questions? Please call (413) 774-6051, or send an email message to <A HREF="mailto:NESEAnetwork@nesea.org">NESEAnetwork@nesea.org</A>.</FONT><BR> <BR> <FORM ACTION="/energy/formmailnetwork.php" METHOD="GET"> <INPUT TYPE="HIDDEN" NAME="origin" VALUE="energy">  <FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2"><B>Fields marked with an asterisk (*) are required.</B><BR><BR></FONT> <TABLE WIDTH="400" CELLPADDING="5" CELLSPACING="0" BORDER="0" ALIGN="center"> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">First Name*:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="Firstname" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Last Name*:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="Lastname" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Email*:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="Email" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Phone:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="Phone" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Job Title:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="Jobtitle" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Organization:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="Organization" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Address:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="Address1" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Address:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="Address2" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">City*:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="City" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">State*:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="State" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD WIDTH="100" ALIGN="right"><B><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Zip Code*:</FONT></B></TD><TD ALIGN="left"><INPUT TYPE="text" NAME="Zip" SIZE="30" MAXLENGTH="60"></TD></TR> <TR><TD COLSPAN="2"><BR><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Tell us about your experience, if any, in the areas of green building, renewable energy, or sustainable transportation:</FONT><BR><TEXTAREA COLS="50" ROWS="5" NAME="Experience"></TEXTAREA><BR><BR> <FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Area(s) of Interest (check as many as apply):</FONT><BR><BR> <INPUT TYPE="checkbox" NAME="Cleanenergy" VALUE="checked"><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Clean Energy</FONT><BR> <INPUT TYPE="checkbox" NAME="Globalwarming" VALUE="checked"><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Global Warming</FONT><BR> <INPUT TYPE="checkbox" NAME="Greenbuilding" VALUE="checked"><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Green Building</FONT><BR> <INPUT TYPE="checkbox" NAME="Transportation" VALUE="checked"><FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Sustainable Transportation</FONT><BR> <FONT FACE="Verdana, Geneva, Arial, Helvetica, sans-serif;" SIZE="2">Other (please specify): </FONT><INPUT TYPE="text" NAME="Otherinterest" VALUE="" SIZE="30" MAXLENGTH="80"> <BR><BR> </TD></TR> </TABLE><BR><BR><INPUT TYPE="SUBMIT" NAME="submit" VALUE="submit"> </FORM>