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All rights reserved.-->
    













	
	
	 
	 
	 
	 

	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	


	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
		
		
	
		

	
		

	
		

	
		

	 
	 
	 
	 

	
	
	
	
	
	
	
	
		
	

	
	 
	
	
	
	
	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	
	
	
	
	
	
	
	
	

	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	
	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

		
	
	
	
	
	
	
	
	
	
	

	
	

	
	

	

	
	

	
	

	
	

	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
		
		
	
		

	
		

	
		

	
		
	
	
		
		
	
		
	
	
		
	
	
	
		
	
	
	
	
	
	
	
	

	
		
	

	
		
	
	
	
	
		
		
			

		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		
		

		
	
	
	
	




	
	
		
	

	
		
	

	
	
	
	
	
	
	
	
	
	

	
	


	
	
		
			
		
	
	
	
	
	
		
			
		
	
	
	
	
	

 


	
	
	
		



		
		
		
		
		
		
		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
			
		
		
			

		

		
		
		
	
		

		
		

		
		
		
		
			
		
		
		
			

		
		

		
		

		
		
		
		
		
		
		
		

		
		
		
		
			

		
		

		
		

		
		
		
		
		
		
		
			

		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		
		
		

		
		
		
		
		
		
			

		
		

		
		

		
		
		
		
		
		
		
			
				

		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		

		

		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		

		
		
		
		


		
			

		

		
		
		

	
		
		
		
		

		


	 
	 
	 
	 

	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	


	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
		
		
	
		

	
		

	
		

	
		

	 
	 
	 
	 
	
	
	
	
	
	
	
	
	
	
	

	
	

	
	

	
	
	
	
	
	
	
	

	
	

	
	

	
	

	
	
	
	
	

	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	
	
	
	

	
	

	
	

	
	




 

		
	

	
	
		





















 

	

 




	


	 

	
	
	 

	
	
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<meta name="description" content="">
<meta name="keywords" content="">
<title>New Member Nomination</title>
<link href="default.css" rel="stylesheet" type="text/css">

				
<script type="text/javascript">
//<!--
var ns4 = (document.layers);
var ie  = (document.all);
var ie4 = (ie && !document.getElementById);
var ie5 = (ie && document.getElementById);
var ns6 = (!ie && document.getElementById);

var aryMoused = new Array();
var aryLayerMoused = new Array();
var aryMoImages = new Array();
var imageList = new Array();
var runMouseOvers = true;
var TimerID = null;
var iLimit = 25;
var itmp = 0;

var nbTime = 100;
var nbTimes = 2;
var nbThisLoc = 325;
var aryLayerNames = new Array();
var aryNavBarLayerInfo = new Array();
var aryNavBarLayers = new Array();

var registeredObjects = new Array();
var viz = "hide";

function MOImage() {
	var arg = MOImage.arguments;
	this.ptrImage = BillzNavBarMM_findObj(arg[0]);
	this.imageMO = new Image();
	this.imageMO.src = arg[1];
	this.HTMLname = arg[0];
	this.Moused = false;
	this.OriginalSrc = '';
	return true;
}

function BillzImagePreload() {
	// 0) html image name 1) mo image src 2)image Name for rollover key (rollover may have multiple mos for one html Image) 
	var arg = BillzImagePreload.arguments;
	nbImagePreload(arg[0], arg[1], arg[2]);
}

function nbImagePreload(img_name, mo_img_src, rollover_key_img_name) {
	var imageKey = (rollover_key_img_name.length > 0) ? rollover_key_img_name : img_name;
	imageList[imageList.length] = imageKey;
	if (!(aryMoImages[imageKey])) aryMoImages[imageKey] = new MOImage(img_name, mo_img_src);
}

function BillzMouseover() {
	var arg = null;
	if (runMouseOvers) {		
		arg = BillzMouseover.arguments; //args 0)ImageName 1)OriginalSrc 2)array index (caller imagename)		
		nbMouseover(arg[0], arg[1], arg[2]);
	}
	return true;
}
// args 1) ImageName 2) OriginalSrc 3) array index (caller imagename)
function nbMouseover(img_name, orig_src, img_key) {
	var imageKey = null;
	var o = null;
	if (runMouseOvers) 
	{				
		imageKey = (img_key.length > 0) ? img_key : img_name;
		if (!(aryMoImages[imageKey].ptrImage)) aryMoImages[imageKey].ptrImage = BillzNavBarMM_findObj(img_name);		
		if (aryMoImages[imageKey] && (o = aryMoImages[imageKey].ptrImage)) {
			aryMoImages[imageKey].OriginalSrc = orig_src;
			aryMoImages[imageKey].Moused = true;
			o.src = aryMoImages[imageKey].imageMO.src;
		}
	}
	return true;
}

var NavBarTempOnload = null;
if (window.onload && window.onload != null) NavBarTempOnload = window.onload;

function FullyLoaded() {
	if (NavBarTempOnload != null) NavBarTempOnload();
	runMouseOvers = true;
	return true;
}

function BillzMouseOutTimer() {
	return nbMouseOutTimer();
}

function nbMouseOutTimer() {
	if (TimerID) clearTimeout(TimerID);
	TimerID = setTimeout("nbLayerRestore()",5000);
	return true;
}

function RestoreAll() {
	nbMouseoverRestore();
	nbLayerRestore();
	return true;
}

function BillzMouseoverRestore() {
	return nbMouseoverRestore();
}

function nbMouseoverRestore() {
	var i = 0;
	var o = null;
	if (runMouseOvers) {
		for (i = 0; i < imageList.length; i++) {
			if (aryMoImages[imageList[i]].Moused && (o = aryMoImages[imageList[i]].ptrImage)) {
				o.src = aryMoImages[imageList[i]].OriginalSrc;
				aryMoImages[imageList[i]].Moused = false;
			}
		}
	}
	return true;
}

function BillzLayerRestore() {
	return nbLayerRestore();
}

function nbLayerRestore() {
	var i = 0;
	for (i = 0; i < aryLayerNames.length; i++) {
		if (!aryNavBarLayerInfo[aryLayerNames[i]].isDefault) BillzNavBarRestoreLayers(aryLayerNames[i]);	
	}
	return true;
}

function BillzArrayPushUnique(aryArray, varNewElement) { //only pushes if unique value
	var pushIt = true;
	var i = 0;
	for (i = 0; i < aryArray.length && pushIt; i++) {
		pushIt = (varNewElement != aryArray[i]);
	}
	if (pushIt) BillzArrayPush(aryArray, varNewElement);
	return pushIt;
}

function BillzArrayPush(aryArray, varNewElement) { //Implement Array Push 'cause IE cant handle it
	aryArray[aryArray.length] = varNewElement;
	return true;
}
function BillzArrayPop(aryArray) { //Implement Array Pop 'cause IE cant handle it before 5.5
	var varItemToPop = null;
	if (aryArray[aryArray.length - 1]) {
		varItemToPop = aryArray[aryArray.length - 1];
		aryArray[aryArray.length] = null;
	}
	return varItemToPop;
}

function getDivRef(id) {
	var divref;
	if(ns4) divref = document.layers[id];
	else if(ie4) divref = document.all[id];
	else if(ie5 || ns6) divref = document.getElementById(id);	
	return divref;
}

//v3.0 name changed to avoid clash with possible other JS in content, this function complements of MM Dreamweaver
function NavBarSwapRollover(swapimage,defaultimage,imageID) {
	if(imageID.length > 0 && document.getElementById(imageID))
	{
		if(swapimage.length > 0) 
			document.getElementById(imageID).src = "images/" + swapimage;
		else
			document.getElementById(imageID).src = "images/" + defaultimage;		
	}
}
function BillzNavBarMM_findObj(n, d) {
	var p,i,x;
	if (ns6) x = document.getElementById(n);
	else {		
		if (registeredObjects[n]) return registeredObjects[n];
		if (!(d)) d = document;
		try {
			p = n.indexOf("?");
		}
		catch(e) {
			p = 0;
		}
		if (p > 0 && parent.frames.length) {
			d = parent.frames[n.substring(p+1)].document;
			n = n.substring(0,p);
		}
		if (!(x = d[n]) && d.all) x = d.all[n];	
		for (i = 0; !x && i < d.forms.length; i++) {
			x = d.forms[i][n];
		}
		for (i=0; !x && d.layers && i < d.layers.length; i++) {
			if (d.layers[i].id.indexOf("external_") == -1) x = BillzNavBarMM_findObj(n, d.layers[i].document);	
		}
		registeredObjects[n] = x;
	}				
	return x;
}

function BillzArrayContains() {
	var arg = BillzArrayContains.arguments;
	var foundit = false;
	var i = 0;
	for (i = 0; i < arg[0].length && !foundit; i++) {
		foundit = (arg[1] == arg[0][i]);
	}
	return foundit;
}

function NavBarRegisterLayer() {
	var arg = NavBarRegisterLayer.arguments;
	var n = arg[0];
	var d = arg[1];
	var mo = false;
	var o = null;
	if (arg[2] && arg[2] == 'MOutLayer') mo = true;
	else mo = false;
	
	if (!(BillzArrayContains(aryLayerNames, n))) {
		if (o = BillzNavBarMM_findObj(n)) {
			aryNavBarLayers[n] = o;
			BillzArrayPushUnique(aryLayerNames, n);
			aryNavBarLayerInfo[n] = new NavBarLayer(n, d, mo);
		}
	}
	return true;
}

function BillzNavBarMM_showHideLayers() {
	//v3.0 name changed, this function complements of MM Dreamweaver with customizations by Bill Heller
	var i = 0;
	var x = "";
	var obj = null;
	var v = null;
	var p = null;
	var args = BillzNavBarMM_showHideLayers.arguments;
	
	if (args[args.length - 1] != "menu") nbMouseOutTimer();
	for (i = 0; i < (args.length - 2); i += 3) {
		if (!aryNavBarLayers[args[i]]) {
			x = (args[i + 2] == 'show') ? 'hide' : 'show';
			NavBarRegisterLayer(args[i], x);
		}
		if ((obj = aryNavBarLayers[args[i]]) != null) {
			v = args[i + 2];
			aryNavBarLayerInfo[args[i]].isDefault = false;
			if (args[args.length - 1] == "restore") v = (v == 'show') ? 'hide' : 'show';
			
			if (obj.style) obj.style.visibility = (v == 'show') ? 'visible' : ((v == 'hide') ? 'hidden' : v);
			else obj.visibility = v;
		}
	}
	return true;
}

function BillzNavBarRestoreLayers() {
	var i = 0;
	var x = "";
	var obj = null;
	var v = null;
	var p = null;
	var args = BillzNavBarRestoreLayers.arguments;
	for (i = 0; i < (args.length); i++) {
		if (obj = aryNavBarLayers[args[i]]) {
			v = aryNavBarLayerInfo[args[i]].defaultVisibility;
			if (obj.style) {
				obj = obj.style;
				v = (v == 'show' ) ? 'visible' : ((v == 'hide') ? 'hidden' : v);
			}
			obj.visibility = v;
			if (!aryNavBarLayerInfo[args[i]].MOutLayer) aryNavBarLayerInfo[args[i]].isDefault = true;			
		}
	}
	return true;
}

function NavBarLayer() {
	var arg = NavBarLayer.arguments;
	this.defaultVisibility = arg[1];
	this.isDefault = true;
	this.MOutLayer = arg[2];
	return true;
}

function BillzNavMove() {
	return nbNavMove();
}

function nbNavMove() {
	var thisl = null;
	var otherl = null;
	if (thisl = BillzNavBarMM_findObj("nbScrollLayer")) {
		if (thisl.style) {
			thisl = thisl.style;
			viz = "hidden";
		} 
		thisl.top = nbThisLoc -= 3;
		if (nbThisLoc < -750) {
			nbThisLoc = 325;
			nbTimes--;
		}
	}
	if (nbTimes <= 0) {
		otherl = BillzNavBarMM_findObj("BillzLayer");
		otherl.visibility = viz;
	} else {
		setTimeout("nbNavMove()", nbTime);
	}	
	return true;
}

function NavBar_openadmin() {
	window.open('admin/','SiteAdmin','height=screen.availheight,width=screen.availwidth,scrollbars=1,toolbar=0,directories=0,status=0,menubar=0,resizable=1');
	return true;
}

window.onload = FullyLoaded;
//-->
</script>
					
<script type="text/javascript">
//<!--
				
nbImagePreload('navigation/top/about_1_1','images/navigation/top/about_on.gif', '');
nbImagePreload('navigation/top/events_1_3','images/navigation/top/events_on.gif', '');
nbImagePreload('navigation/top/announcements_1_4','images/navigation/top/announcements_on.gif', '');
nbImagePreload('navigation/top/reading_1_5','images/navigation/top/reading_on.gif', '');

//-->
</script>
<script type="text/javascript">
//<!--
function NavBar_setCookie(cookievalue,navVersion,linkID) 
{	
	var cookiename = "SLIDINGTABLE_NAVBAR" + navVersion;
	var cookieVersionname = "SLIDINGTBL_NAVBAR_VERSION";
	var cookieClear = "SLIDINGTBL_NAVBAR_CLEARCOOKIES";	
	document.cookie = cookieClear.toUpperCase() + "=false";
	if(cookievalue.length > 0)
		document.cookie = cookiename.toUpperCase() + "=" + escape(cookievalue);
	if(navVersion.length > 0)	
		document.cookie = cookieVersionname.toUpperCase() + "=" + navVersion;	
	if(linkID.length > 0)
		NavBar_setPLinkIDCookie(linkID,navVersion);		
}
function NavBar_setoLevelIDCookie(cookievalue,linkID,navVersion) 
{
	var name = "SLIDINGTBL_NAVBAR_OLEVELID";		
	if(cookievalue.length > 0)
		document.cookie = name.toUpperCase() + "=" + escape(cookievalue);	
	if(linkID.length > 0)
		NavBar_setPLinkIDCookie(linkID,navVersion);	
	if(navVersion.length > 0)	
		document.cookie = "SLIDINGTBL_NAVBAR_VERSION=" + navVersion;		
}
function NavBar_setPLinkIDCookie(linkID,navVersion)
{	
	document.cookie = "SLIDINGTBL_NAVBAR_PLINKID=" + linkID;	
	if(navVersion.length > 0)	
		document.cookie = "SLIDINGTBL_NAVBAR_VERSION=" + navVersion;
}
function NavBar_deleteCookie() 
{
	// first we'll split this cookie up into name/value pairs
	// note: document.cookie only returns name=value, not the other components
	var check_name = "SLIDINGTABLE_NAVBAR";	
	var a_all_cookies = document.cookie.split( ';' );
	var a_temp_cookie = '';
	var cookie_name = '';
	var cookie_value = '';
	var b_cookie_found = false; // set boolean t/f default f	

	document.cookie = "SLIDINGTBL_NAVBAR_VERSION=0";	
	document.cookie = "SLIDINGTBL_NAVBAR_OLEVELID=";	
	for (i = 0; i < a_all_cookies.length; i++)
	{		
		a_temp_cookie = a_all_cookies[i].split( '=' );			
		cookie_name = a_temp_cookie[0].replace(/^\s+|\s+$/g, '');
		
		//expire all cookies for every slidingTable_navbar intances.			
		if (cookie_name.toUpperCase().indexOf(check_name) == 0)		
			document.cookie = cookie_name.toUpperCase() + "=";			 	
	}	
}
		
//-->
</script>
			
	    <style type="text/css">
	    <!--
	    @import url("module.css");
	    -->
	    </style>
	</head>
	


<body style="margin:0px; background-image:url(images/background.gif);background-position:top center; background-repeat: repeat-y; background-color:#094359;">
<br />
<table width="1%" border="0" align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td width="1%" align="left" valign="top"><table width="1%" border="0" align="left" cellpadding="0" cellspacing="0">
      <tr>
        <td colspan="3"><table width="100%" cellpadding="0" cellspacing="0">
          <tr>
            <td align="left" valign="top" width="1%" style="background-image:url(images/element/wrap_left_top.gif); background-position:bottom left; background-repeat:no-repeat;"><img src="images/element/w30.gif" /></td>
            <td align="left" valign="top" width="98%" style="background-image:url(images/element/wrap_top.gif); background-position:bottom left; background-repeat:repeat-x;">&nbsp;</td>
            <td align="left" valign="top" width="1%" style="background-image:url(images/element/wrap_right_top.gif); background-position:bottom right; background-repeat:no-repeat;"><img src="images/element/w30.gif" /></td>
          </tr>
        </table></td>
      </tr>
      <tr>
        <td width="1%" align="left" valign="top" style="background-image:url(images/element/wrap_left.gif); background-position:top right; background-repeat:repeat-y"><img src="images/element/h12.gif" alt="" width="12" height="1" /></td>
        <td width="98%" align="left" valign="top"><table width="736" height="130" border="0" align="center" cellpadding="0" cellspacing="0">
          <tr>
            <td align="left" valign="top" background="images/element/header.gif"><table width="100%" height="130" border="0" cellpadding="0" cellspacing="0">
              <tr>
                <td align="left" valign="top" style="padding-left:35px; padding-top:12px; background-image:url(images/banner/banner1.gif); background-position:top right; background-repeat:no-repeat;"><table width="100%" height="115" border="0" cellpadding="0" cellspacing="0">
                  <tr>
                    <td width="1%" align="left" valign="top"><a href="homepage.cfm"><img src="images/logo.gif" alt="" width="130" height="105" border="0" onMouseOver="this.src='images/logo_over.gif';" onMouseOut="this.src='images/logo.gif';"/></a></td>
                    <td width="99%" align="right" valign="bottom" style="padding-right:15px;"><a href="body.cfm?id=53"><img src="images/element/w30.gif" width="160" height="15" border="0"></a></td>
                  </tr>
                </table></td>
              </tr>
            </table></td>
          </tr>
        </table>
              <table width="100%" border="0" cellpadding="0" cellspacing="0">
                <tr>
                  <td align="center" valign="top" style="height:31px;background-image:url(images/navigation/tile_top.gif); background-position:top left; background-repeat:repeat-x;">
	<!-- Begin NavBar Output  -  Version:  v0.79a 09/30/2006  -->
	
		<!-- Begin NavBar Bar #1 Content Output... -->
		<table  border="0" cellspacing="0" cellpadding="0" onclick="NavBar_deleteCookie();">
	<tr class="">
		<td class="" valign="top" align="left"><img src="images/navigation/brk_top.gif" alt=""></td>
		<td class="" valign="top" align="left" title=""><a href="body.cfm?id=6"  onMouseOver="RestoreAll();nbMouseover('navigation/top/about_1_1','images/navigation/top/about.gif','');" onMouseOut ="nbMouseoverRestore();" onClick="NavBar_setPLinkIDCookie('6','');" class=""><img src="images/navigation/top/about.gif" border="0" alt="About X2" id="navigation/top/about_1_1" name="navigation/top/about_1_1"></a></td>
		<td class="" valign="top" align="left" title=""><img src="images/navigation/brk_top.gif" alt=""></td>
		<td class="" valign="top" align="left" title=""><a href="body.cfm?id=44"  onMouseOver="RestoreAll();nbMouseover('navigation/top/events_1_3','images/navigation/top/events.gif','');" onMouseOut ="nbMouseoverRestore();" onClick="NavBar_setPLinkIDCookie('44','');" class=""><img src="images/navigation/top/events.gif" border="0" alt="Upcoming Events for 2010-2011" id="navigation/top/events_1_3" name="navigation/top/events_1_3"></a></td>
		<td class="" valign="top" align="left" title=""><img src="images/navigation/brk_top.gif" alt=""></td>
		<td class="" valign="top" align="left" title=""><a href="body.cfm?id=27"  onMouseOver="RestoreAll();nbMouseover('navigation/top/announcements_1_4','images/navigation/top/announcements.gif','');" onMouseOut ="nbMouseoverRestore();" onClick="NavBar_setPLinkIDCookie('27','');" class=""><img src="images/navigation/top/announcements.gif" border="0" alt="Announcements" id="navigation/top/announcements_1_4" name="navigation/top/announcements_1_4"></a></td>
		<td class="" valign="top" align="left" title=""><img src="images/navigation/brk_top.gif" alt=""></td>
		<td class="" valign="top" align="left" title=""><a href="body.cfm?id=37"  onMouseOver="RestoreAll();nbMouseover('navigation/top/reading_1_5','images/navigation/top/reading.gif','');" onMouseOut ="nbMouseoverRestore();" onClick="NavBar_setPLinkIDCookie('37','');" class=""><img src="images/navigation/top/reading.gif" border="0" alt="Reading Room" id="navigation/top/reading_1_5" name="navigation/top/reading_1_5"></a></td>
		<td class="" valign="top" align="left"><img src="images/navigation/brk_top.gif" alt=""></td>
	</tr>
</table>
	
		<!-- End NavBar Output -->
	 
</td>
                </tr>
            </table></td>
        <td width="1%" align="left" valign="top" style="background-image:url(images/element/wrap_right.gif); background-position:top left; background-repeat:repeat-y"><img src="images/element/h12.gif" alt="" width="12" height="1" /></td>
      </tr>
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            <td align="left" valign="top" style="padding-top:3px;"><span class="welcome">Welcome X2 Healthcare Network Guest</span></td>
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        <td align="left" valign="top" style="background-image:url(images/element/wrapx_left.gif); background-position:top right; background-repeat:repeat-y">&nbsp;</td>
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		 <table width="100%" border="0" cellspacing="0" cellpadding="0">
		
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			<table width="100%" border="0" cellspacing="0" cellpadding="0">
			
			
			
			
				
				
				
						
			
				
			
			
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                    <td colspan="3" rowspan="2" align="left" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0">
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                          <td align="center" valign="top"><a href="body.cfm?id=65"><img src="images/caption/discussion.gif" alt="" width="168" height="21" border="0"/></a></td>
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                          <td align="left" valign="top" style="padding-left:15px;padding-right:15px;padding-top:4px;">
						  
		
		
		

		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
		
		

		
		

		
		

		
		
		
		
		
		
		
			
				
				

				
				

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

				
			
		
		

		
		
		

		
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                    <td align="right" valign="top" style="background-image:url(images/container/trc.gif); background-position:top left; background-repeat:no-repeat;">&nbsp;</td>
                  </tr>
                  <tr>
                    <td align="left" valign="top" style="background-image:url(images/container/blc.gif); background-position:bottom right; background-repeat:repeat-y;">&nbsp;</td>
                    <td align="right" valign="top" style="background-image:url(images/container/brc.gif); background-position:bottom left; background-repeat:repeat-y;">&nbsp;</td>
                  </tr>
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                    <td align="right" valign="top" style="background-image:url(images/container/bl.gif); background-position:top right; background-repeat:no-repeat;">&nbsp;</td>
                    <td align="left" valign="top" style="background-image:url(images/container/bcl.gif); background-position:top right; background-repeat:no-repeat;">&nbsp;</td>
                    <td align="left" valign="top" style="background-image:url(images/container/b.gif); background-position:top left; background-repeat:repeat-x;">&nbsp;</td>
                    <td align="left" valign="top" style="background-image:url(images/container/bcr.gif); background-position:top right; background-repeat:no-repeat;">&nbsp;</td>
                    <td align="left" valign="top" style="background-image:url(images/container/br.gif); background-position:top left; background-repeat:no-repeat;">&nbsp;</td>
                  </tr>
                </table></td>
              </tr>
			  
			  
			  
			  
			  
			  
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                <td align="left" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0">
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                    <td width="1%" align="right" valign="top" style="background-image:url(images/container/tl.gif); background-position:bottom right; background-repeat:no-repeat;"><img src="images/container/w12.gif" alt="" width="12" height="1" /></td>
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                    <td width="96%" align="left" valign="top" style="background-image:url(images/container/t.gif); background-position:bottom left; background-repeat:repeat-x;">&nbsp;</td>
                    <td width="1%" align="left" valign="top" style="background-image:url(images/container/tcr.gif); background-position:bottom left; background-repeat:no-repeat;"><img src="images/container/w14.gif" alt="" width="14" height="1" /></td>
                    <td width="1%" align="left" valign="top" style="background-image:url(images/container/tr.gif); background-position:bottom left; background-repeat:no-repeat;"><img src="images/container/w12.gif" alt="" width="12" height="1" /></td>
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                    <td align="left" valign="top" style="background-image:url(images/container/tlc.gif); background-position:top right; background-repeat:no-repeat;"><img src="images/container/h12.gif" alt="" width="1" height="12" /></td>
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                          <td align="center" valign="top"><img src="images/caption/sponsor.gif" alt="" width="168" height="21" /></td>
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                          <td align="center" valign="top">
						  
						<table border="0" cellspacing="4" cellpadding="0" width="100%">
<tbody>
<tr>
<td align="center" valign="top"><img src="images/element/h12.gif" border="0" width="12" height="1" /></td>
</tr>
<tr>
<td align="center" valign="top">
<p><a href="http://www.careseek.com" target="_blank"></a></p>
<p style="text-align: center;"><img class="sm6generalwizard" src="images/HMS.jpg" border="0" /><a href="http://healthmediasyndicate.com" target="_blank"></a></p>
</td>
</tr>
<tr>
<td>&nbsp;
<div style="text-align: center"><a href="http://www.unsummit.com/" target="_blank"><img class="sm6generalwizard" src="images/Logo_terra_150.jpg" border="0" width="150" height="24" /></a>&nbsp;<br /><img class="sm6generalwizard" src="images/leftnavbkgrd.gif" border="0" width="172" height="1" /></div>
</td>
</tr>
<tr>
<td>&nbsp;
<div style="text-align: center"><a href="http://www.acmarketingpr.com/" target="_blank"><img class="sm6generalwizard" src="images/Logo_amcomm_150.jpg" border="0" width="150" height="26" /></a><br /></div>
<div style="text-align: center"><img class="sm6generalwizard" src="images/leftnavbkgrd.gif" border="0" width="172" height="1" /></div>
</td>
</tr>
<tr>
<td>&nbsp;
<div style="text-align: center"><a href="http://www.medseek.com" target="_blank"><img class="sm6generalwizard" src="images/medseek.jpg" border="0" width="147" height="27" /></a>&nbsp;<br /><img class="sm6generalwizard" src="images/leftnavbkgrd.gif" border="0" width="172" height="1" /></div>
</td>
</tr>
<tr>
<td><a href="http://www.epochday.com" target="_blank">
<p style="text-align: center;"><img class="sm6generalwizard" src="images/EDS_logo_sm.jpg" border="0" /></p>
</a></td>
</tr>
</tbody>
</table>
<div style="text-align: center"><a href="http://www.epochday.com" target="_blank"></a></div>
<div style="text-align: center"><a href="http://www.billableatthebeach.com/" target="_blank"><img class="sm6generalwizard" src="images/billable%20at%20beachsm.jpg" border="0" /></a></div>
						  </td>
                        </tr>
                    </table></td>
                    <td align="right" valign="top" style="background-image:url(images/container/trc.gif); background-position:top left; background-repeat:no-repeat;">&nbsp;</td>
                  </tr>
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                    <td align="left" valign="top" style="background-image:url(images/container/blc.gif); background-position:bottom right; background-repeat:repeat-y;">&nbsp;</td>
                    <td align="right" valign="top" style="background-image:url(images/container/brc.gif); background-position:bottom left; background-repeat:repeat-y;">&nbsp;</td>
                  </tr>
                  <tr>
                    <td align="right" valign="top" style="background-image:url(images/container/bl.gif); background-position:top right; background-repeat:no-repeat;">&nbsp;</td>
                    <td align="left" valign="top" style="background-image:url(images/container/bcl.gif); background-position:top right; background-repeat:no-repeat;">&nbsp;</td>
                    <td align="left" valign="top" style="background-image:url(images/container/b.gif); background-position:top left; background-repeat:repeat-x;">&nbsp;</td>
                    <td align="left" valign="top" style="background-image:url(images/container/bcr.gif); background-position:top right; background-repeat:no-repeat;">&nbsp;</td>
                    <td align="left" valign="top" style="background-image:url(images/container/br.gif); background-position:top left; background-repeat:no-repeat;">&nbsp;</td>
                  </tr>
                </table></td>
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            </table></td>
            <td width="99%" height="400"align="left" valign="top" style="padding-left:10px;">
				
				<table width="100%" border="0" cellpadding="0" cellspacing="0">
					<tr>
						<td align="left" valign="top" style="padding-top:2px;padding-bottom:5px;"><span class="title">New Member Nomination</span></td>
					</tr>
					<tr>
						<td align="left" valign="top">

	
		


 

<script type="text/javascript" src="http://bur-ms-sm6-04a.medseek.com/sm_FormValidation.js"></script>
		<form name="eform" method="post" action="http://x2hn.org/body.cfm?xyzpdqabc=0&amp;id=53&amp;action=submiteform" onSubmit="return (sm_ValidateForm(this) && sm_removeALLrequiredhiddenfields(this));" class="metadetail">
		<table class="metadetail">
			<tr class="metadetail">
				<td class="metadetail" colspan="2">Please review the <ahref="body.cfm?id=15">Membership Guidelines</a> before nominating a new member.&nbsp;&nbsp;Qualified nominees will receive a Welcome e-mail, naming you as the nominating member and citing your "Comments".&nbsp;&nbsp;To become a full member, your Nominee will be asked to explore the X2HN portal as a guest, and proactively submit a reply e-mail agreeing to accept the Membership Guidelines and request full membership.&nbsp;&nbsp;In order to grow a vital membership of top level women in the healthcare industry, you are encouraged to explain our Mission and Goals to your nominee and act as an ambassador (enthusiastic evangelist) of the X2 Healthcare Network!&nbsp;&nbsp;<br><br></td>
			</tr>
			<tr class="metadetail">
				<td class="metadetail" colspan="2"><span class="required">
				* Indicates required information</span></td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Name of Nominee&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_1" class="metadetail" size="35" value="">
					<input type="Hidden" name="eformField_1_required" class="metadetail" value="Name of Nominee is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Title&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_2" class="metadetail" size="35" value="">
					<input type="Hidden" name="eformField_2_required" class="metadetail" value="Title is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Organization&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_3" class="metadetail" size="35" value="">
					<input type="Hidden" name="eformField_3_required" class="metadetail" value="Organization is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Email Address&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_4" class="metadetail" size="35" value="">
					  
					<input type="Hidden" name="eformField_4_email" class="metadetail" value="Email Address must be a valid email address.">
					<input type="Hidden" name="eformField_4_required" class="metadetail" value="Email Address is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Phone&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_5" class="metadetail" size="35" value="">
					<input type="Hidden" name="eformField_5_required" class="metadetail" value="Phone is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Street Address 1&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_6" class="metadetail" size="35" value="">
					<input type="Hidden" name="eformField_6_required" class="metadetail" value="Street Address 1 is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Street Address 2&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_7" class="metadetail" size="35" value="">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">City&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_8" class="metadetail" size="35" value="">
					<input type="Hidden" name="eformField_8_required" class="metadetail" value="City is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">State&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<select name="eformField_9" id="eformField_9" class="metadetail">
						<option value="AK" selected>AK</option>
						<option value="AL">AL</option>
						<option value="AR">AR</option>
						<option value="AZ">AZ</option>
						<option value="CA">CA</option>
						<option value="CO">CO</option>
						<option value="CT">CT</option>
						<option value="DC">DC</option>
						<option value="DE">DE</option>
						<option value="FL">FL</option>
						<option value="GA">GA</option>
						<option value="HI">HI</option>
						<option value="IA">IA</option>
						<option value="ID">ID</option>
						<option value="IL">IL</option>
						<option value="IN">IN</option>
						<option value="KS">KS</option>
						<option value="KY">KY</option>
						<option value="LA">LA</option>
						<option value="MA">MA</option>
						<option value="MD">MD</option>
						<option value="ME">ME</option>
						<option value="MI">MI</option>
						<option value="MN">MN</option>
						<option value="MO">MO</option>
						<option value="MS">MS</option>
						<option value="MT">MT</option>
						<option value="NC">NC</option>
						<option value="ND">ND</option>
						<option value="NE">NE</option>
						<option value="NH">NH</option>
						<option value="NJ">NJ</option>
						<option value="NM">NM</option>
						<option value="NV">NV</option>
						<option value="NY">NY</option>
						<option value="OH">OH</option>
						<option value="OK">OK</option>
						<option value="OR">OR</option>
						<option value="PA">PA</option>
						<option value="PR">PR</option>
						<option value="RI">RI</option>
						<option value="SC">SC</option>
						<option value="SD">SD</option>
						<option value="TN">TN</option>
						<option value="TX">TX</option>
						<option value="UT">UT</option>
						<option value="VA">VA</option>
						<option value="VT">VT</option>
						<option value="WA">WA</option>
						<option value="WI">WI</option>
						<option value="WV">WV</option>
						<option value="WY">WY</option>
					</select>
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Zip&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_10" class="metadetail" size="35" value="">
					<input type="Hidden" name="eformField_10_required" class="metadetail" value="Zip is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Country&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_11" class="metadetail" size="35" value="">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Your Name&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_12" class="metadetail" size="35" value="">
					<input type="Hidden" name="eformField_12_required" class="metadetail" value="Your Name is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Your Phone&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<input type="Text" name="eformField_13" class="metadetail" size="35" value="">
					<input type="Hidden" name="eformField_13_required" class="metadetail" value="Your Phone is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Your reason for nominating this person&nbsp;<span class="required">*</span>&nbsp;</th>
				<td class="metadetail">
					<textarea name="eformField_14" class="metadetail" cols="40" rows="5"></textarea>
					<input type="Hidden" name="eformField_14_required" class="metadetail" value="Your reason for nominating this person is required.">
				</td>
			</tr>
			<tr class="metadetail">
				<th valign="top" class="metadetail">Additional comments that you wish to be passed on in your nominee's &quot;Welcome&quot; letter&nbsp;</th>
				<td class="metadetail">
					<textarea name="eformField_15" class="metadetail" cols="40" rows="5"></textarea>
				</td>
			</tr>
			



	









	




	
	
	
	
	
	
	
	
		
	
	
	
	

	
		
			
		
		
		
		
			
			
			
			
				
				
			
		
		
	



	
	
	
	
	
		
			
				<tr class="metadetail">
					<th  class="metadetail">Authentication&nbsp;<span class="required">*</span>&nbsp;<br><br><div align="left" style="font-weight: normal; font-size: smaller; display: inline; width:120px;">If the challenge words are too difficult to read, <a href="javascript:Recaptcha.reload();">click here</a> to refresh.</div></th>
					<td class="metadetail">
			
		
		
			
				<input type=hidden name="recaptcha_response_field_required" value="Authentication is required."><script type="text/javascript" src="http://api.recaptcha.net/challenge?k=6LfTeQQAAAAAAMALbe7DuSNLwEFH6nWJ5z-hdbuD"></script>
				<noscript>
				   <iframe src="http://api.recaptcha.net/noscript?k=6LfTeQQAAAAAAMALbe7DuSNLwEFH6nWJ5z-hdbuD"
				       height="300" width="500" frameborder="0"></iframe><br>
				   <textarea name="recaptcha_challenge_field" rows="3" cols="40">
				   </textarea>
				   <input type="hidden" name="recaptcha_response_field" 
				       value="manual_challenge">
				</noscript>
			
		
		
			
					</td>
				</tr>
			
		
	












 

			<tr class="metadetail">
				<th class="metadetail">&nbsp;</th>
				<td class="metadetail">
					<input type="submit" name="submit" value="Submit" class="metadetail">
				</td>
			</tr>
		</table>
		</form>
	
	

 

	
 
</td>
					</tr>
				</table>
				
			</td>
          </tr>
        </table>
		
		</td>
        <td align="left" valign="top" style="background-image:url(images/element/wrapx_right.gif); background-position:top left; background-repeat:repeat-y">&nbsp;</td>
      </tr>
      <tr>
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