ChinMania - Chin Owners Directory: Sign-up & Update Form

Sign-up & Update Form

Chin Owners Directory

Name or Nickname: [required]

Listing Status: [required]

Preferred E-mail Address: [required]

Country: [required]

Province/State/Region: [recommended]

Nearest large City: [optional]

Website URL: [optional]

Instant Messenger: ICQ #:
AOL IM:
MSN IM:
Yahoo IM:
Other IM:    [optional]

Number of Chins:
    [+ Gender] [recommended]

Type of Owner: * [recommended]

If Other:

* Type of Owner:

Pet Owner = usually those Chin Owners with fewer than
   10 Chins

Hobby Breeder = generally those with 10-20 Chins and have
   kits available on a semi-regular basis.

Breeder = typically those with larger numbers of Chins
   & kits available on a regular basis.

Details for your pop-up Extra Information Window:    [optional]

Type in your Extra Information here. You may include such information about your Chinchilla(s) as: * Name * Gender * Birthdate * Colour * Photos Obviously, photographs must be sent as e-mail attachments directly to ChinMania@gmail.com You may also provide: * a summary of your other animals * personal contact information [telephone, fax, pager #'s, street address, etc] * small advertising buttons/graphics * URL's for a Chinchilla or animal related site

Comments: [about the Signup Form or the Chin Owners Directory] [optional]

Comments about the Signup Form or the Chin Owners Directory


                         Click once

This form has been successfully tested with Netscape 4.x and Microsoft Internet Explorer 4.x Browsers.

FREE feedback form powered by Freedback.com