Please tell us some of the nuts and bolts of your planning for this year's trip to Burning Man with Freedomcommunity.<form method="post" action="http://www.emailmeform.com/fid.php?formid=71892" enctype="multipart/form-data" accept-charset="UTF-8">
<table cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF">
<tr>
<td>
<font face="Verdana" size="2" color="#000000"></font>
 <div style="" id="mainmsg"> </div>

</td>
</tr>
</table>

<br>

<table cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF">

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000">Your Name</font></td>
 <td><input type="text" name="FieldData0" size="30"> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000">Your Email Address</font></td>
 <td><input type="text" name="FieldData1" size="30"> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000">Your Phone Number</font></td>
 <td><input type="text" name="FieldData2" size="30"> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000">Prefered Method of Contact</font></td>
 <td><input type=radio name="FieldData3" value="Call Me!" id="radio30"><font face="Verdana" size="2" color="#000000"><label for="radio30">Call Me!</label></font><br><input type=radio name="FieldData3" value="Email" id="radio31"><font face="Verdana" size="2" color="#000000"><label for="radio31">Email</label></font><br><input type=radio name="FieldData3" value="Text Message" id="radio32"><font face="Verdana" size="2" color="#000000"><label for="radio32">Text Message</label></font><br> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000">How many times have you been to Burning Man?</font></td>
 <td><input type=radio name="FieldData4" value="This is my first time" id="radio40"><font face="Verdana" size="2" color="#000000"><label for="radio40">This is my first time</label></font><br><input type=radio name="FieldData4" value="I have been once before" id="radio41"><font face="Verdana" size="2" color="#000000"><label for="radio41">I have been once before</label></font><br><input type=radio name="FieldData4" value="I have been twice" id="radio42"><font face="Verdana" size="2" color="#000000"><label for="radio42">I have been twice</label></font><br><input type=radio name="FieldData4" value="I have been over three times" id="radio43"><font face="Verdana" size="2" color="#000000"><label for="radio43">I have been over three times</label></font><br> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000">How many times have you camped with Freedomcommunity?</font></td>
 <td><input type=radio name="FieldData5" value="This is my first time with Freedomcommunity" id="radio50"><font face="Verdana" size="2" color="#000000"><label for="radio50">This is my first time with Freedomcommunity</label></font><br><input type=radio name="FieldData5" value="I have been once before" id="radio51"><font face="Verdana" size="2" color="#000000"><label for="radio51">I have been once before</label></font><br><input type=radio name="FieldData5" value="I have been twice" id="radio52"><font face="Verdana" size="2" color="#000000"><label for="radio52">I have been twice</label></font><br><input type=radio name="FieldData5" value="I have been over three times" id="radio53"><font face="Verdana" size="2" color="#000000"><label for="radio53">I have been over three times</label></font><br> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000">How are you getting to the Burn?</font></td>
 <td><input type="text" name="FieldData6" size="30"> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000">What are you interested in experiencing at Burning Man?</font></td>
 <td><textarea name="FieldData7" cols="60" rows="10"></textarea><br> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000">How are you interested in contributing?</font></td>
 <td><input type=checkbox name="FieldData8-0" value="Fundraising" id="check80"><font face="Verdana" size="2" color="#000000"><label for="check80">Fundraising</label></font><br><input type=checkbox name="FieldData8-1" value="Art Car" id="check81"><font face="Verdana" size="2" color="#000000"><label for="check81">Art Car</label></font><br><input type=checkbox name="FieldData8-2" value="Construction" id="check82"><font face="Verdana" size="2" color="#000000"><label for="check82">Construction</label></font><br><input type=checkbox name="FieldData8-3" value="
Dome Decor Installation and Creation" id="check83"><font face="Verdana" size="2" color="#000000"><label for="check83">
Dome Decor Installation and Creation</label></font><br><input type=checkbox name="FieldData8-4" value=" 
Infrastructure" id="check84"><font face="Verdana" size="2" color="#000000"><label for="check84"> 
Infrastructure</label></font><br><input type=checkbox name="FieldData8-5" value=" Kitchen/Food" id="check85"><font face="Verdana" size="2" color="#000000"><label for="check85"> Kitchen/Food</label></font><br><input type=checkbox name="FieldData8-6" value=" Workshops" id="check86"><font face="Verdana" size="2" color="#000000"><label for="check86"> Workshops</label></font><br><input type=checkbox name="FieldData8-7" value=" Leave No Trace" id="check87"><font face="Verdana" size="2" color="#000000"><label for="check87"> Leave No Trace</label></font><br><input type=checkbox name="FieldData8-8" value=" Massage/Healing Gifts" id="check88"><font face="Verdana" size="2" color="#000000"><label for="check88"> Massage/Healing Gifts</label></font><br><input type=checkbox name="FieldData8-9" value=" Transportation" id="check89"><font face="Verdana" size="2" color="#000000"><label for="check89"> Transportation</label></font><br><input type=checkbox name="FieldData8-10" value=" Music" id="check810"><font face="Verdana" size="2" color="#000000"><label for="check810"> Music</label></font><br><input type=checkbox name="FieldData8-11" value=" Fire Art" id="check811"><font face="Verdana" size="2" color="#000000"><label for="check811"> Fire Art</label></font><br> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000"></font></td>
 <td><input type="text" name="FieldData9" size="30"> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000"></font></td>
 <td><input type="text" name="FieldData10" size="30"> </td>
</tr>

<tr valign="top">
 <td nowrap><font face="Verdana" size="2" color="#000000">How sure are you that you will be camping with Freedomcommunity?</font></td>
 <td><input type=radio name="FieldData11" value="I am definitely going to Burning Man and camping with FC" id="radio110"><font face="Verdana" size="2" color="#000000"><label for="radio110">I am definitely going to Burning Man and camping with FC</label></font><br><input type=radio name="FieldData11" value="There's a 75% chance I will be camping with FC" id="radio111"><font face="Verdana" size="2" color="#000000"><label for="radio111">There's a 75% chance I will be camping with FC</label></font><br><input type=radio name="FieldData11" value="There's a 50% chance I will be camping with FC" id="radio112"><font face="Verdana" size="2" color="#000000"><label for="radio112">There's a 50% chance I will be camping with FC</label></font><br><input type=radio name="FieldData11" value="There's a 25% chance I will be camping with FC" id="radio113"><font face="Verdana" size="2" color="#000000"><label for="radio113">There's a 25% chance I will be camping with FC</label></font><br><input type=radio name="FieldData11" value="I will definitely not be camping with FC" id="radio114"><font face="Verdana" size="2" color="#000000"><label for="radio114">I will definitely not be camping with FC</label></font><br> </td>
</tr>

<tr>
 <td colspan="2">
<table cellpadding=5 cellspacing=0 bgcolor="#E4F8E4" width="100%">
<tr bgcolor="#AAD6AA">
<td class="label" colspan="2"><font color="#FFFFFF" face="Verdana" size="2"><b>Image Verification</b></font></td>
</tr>
<tr>
<td class="captcha" style="padding: 2px;" width="10"><img src="http://www.emailmeform.com/turing.php" id="captcha" alt="captcha"></td>
<td class="field" valign="top"><div><font color="#000000">Please enter the text from the image</font>:<br><input type="text" name="Turing" value="" maxlength="100" size="10">
 [ <a href="#" onclick=" document.getElementById('captcha').src = document.getElementById('captcha').src + '?' + (new Date()).getMilliseconds()">Refresh Image</a> ] [ <a href="http://www.emailmeform.com/?v=turing&amp;pt=popup" onClick="window.open('http://www.emailmeform.com/?v=turing&amp;pt=popup','_blank','width=400, height=500, left=' + (screen.width-450) + ', top=100');return false;">What's This?</a> ]</div>
</td>
</tr>
</table></td>
</tr>
<tr>
 <td>
 </td>
 <td align="middle">
<input type="text" name="hida2" value="" maxlength="100" size="3" style="display : none;">
<input type="submit" class="btn" value="Submit" name="Submit"></td>
</tr>
<tr>
<td colspan=2 align="center">
<br>
</td>
</tr>
</table>

</form>Thank you for filling out this form!  Send the link to this survey to your friends who might also want to camp with us!  You will now be returned to the Freedomcommunity Burns Tribe.