ÿþ<html> <body> <form action="MAILTO:INFO@IMGA.ORG.IL" method="post" enctype="text/plain"> <div style="text-align: center;" dir="rtl"> <span style="font-weight: bold;">(ÞÙÜÕÙ ÔØÕäá ÞÔÕÕÔ êàÐÙ ÒÝ ÜÔæØèäÕê ÜêÛàÙê ÜÔáÞÛÔ ÑÙàÜÐÕÞÙê - IFMGA) </span> <br></br> <br></br> <form> <form action="MAILTO:info@imga.org.il" method="post" enctype="text/plain"> <div style="text-align: right;" dir="rtl"> <span style="font-weight: bold;">1. äèØÙÝ ÐÙéÙÙÝ </span> <br></br> éÝ äèØÙ <input type="text" name="he_name"> éÝ Þéä×Ô <input type="text" name="he_surname"> <br></br> éÝ äèØÙ - ÐàÒÜÙê <input type="text" name="he_name"> éÝ Þéä×Ô - ÐàÒÜÙê <input type="text" name="he_surname"> <br></br> ê.Ö. <input type="text" name="tz"> êÐèÙÚ ÜÙÓÔ <input type="text" name="birth_date"> <br></br> ÐÖè×Õê <input type="text" name="nation"> Þá' ÓèÛÕß <input type="text" name="pass"> <br></br> ÛêÕÑê <input type="text" name="addr"> ÞÙçÕÓ <input type="text" name="zip"> <br></br> ØÜäÕß ÑÑÙê <input type="text" name="home_no"> ØÜäÕß ÑâÑÕÓÔ <input type="text" name="work_no"> <br></br> ØÜäÕß àÙÙÓ <input type="text" name="cell_no"> <br></br> ÓÕÐè ÐÜçØèÕàÙ (e-mail) <input type="text" name="email"> <br></br> éäÕê: <br></br> éäÔ 1 <input type="text" name="language"> <br></br> ÑÓÙÑÕè <select name="talk_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="talk_level"> ÑçèÙÐÔ <select name="read_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="read_level"> ÑÛêÙÑÔ <select name="write_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="write_level"> <br></br> éäÔ 2 <input type="text" name="language"> <br></br> ÑÓÙÑÕè <select name="talk_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="talk_level"> ÑçèÙÐÔ <select name="read_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="read_level"> ÑÛêÙÑÔ <select name="write_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="write_level"> <br></br> éäÔ 3 <input type="text" name="language"> <br></br> ÑÓÙÑÕè <select name="talk_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="talk_level"> ÑçèÙÐÔ <select name="read_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="read_level"> ÑÛêÙÑÔ <select name="write_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="write_level"> <br></br> éäÔ 4 <input type="text" name="language"> <br></br> ÑÓÙÑÕè <select name="talk_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="talk_level"> ÑçèÙÐÔ <select name="read_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="read_level"> ÑÛêÙÑÔ <select name="write_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4"> ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="write_level"> <br></br> éäÔ 5 <input type="text" name="language"> <br></br> ÑÓÙÑÕè <select name="talk_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4">ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="talk_level"> ÑçèÙÐÔ <select name="read_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4">ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="read_level"> ÑÛêÙÑÔ <select name="write_level"> <option value="1">éäê ÐÝ <option value="2">ØÕÑÔ <option value="3">ÜÐ èâÔ <option value="4">ÑÙàÕàÙê <option value="5">ÑáÙáÙê </select name="write_level"> <br></br> <span style="font-weight: bold;">2. àáÙÕß ÑØÙäÕá </span> <br></br> Ð. ÞØäá/ê Þéàê: <input type="text" name="climbing_since"> <br></br> Ñ. ÞÕÑÙÜ/Ô Þéàê: <input type="text" name="leading_since"> <br></br> Ò. ÞÕÑÙÜ/Ô âÜ ÐÑàÙ âÙÒÕß Þéàê: <input type="text" name="trad_leading_since"> <br></br> Ó. ÞØäá ÐÜäÙàÙ Þéàê: <input type="text" name="alpine_climbing_since"> <br></br> Ô. ÐÙÜÕ çÕèáÙ ØÙäÕá âéÙê, ÞêÙ, ÐÙäÔ, ÑÔÓèÛê ÞÙ? <textarea name="info" rows="5" cols="50"></textarea> <br></br> Õ. ÑÐÙÜÕ ÞÓÙàÕê ØÙäáê ÕÑÐÙÖÔ áÒàÕß (ÐÑàÙ âÙÒÕß, âÜ ÑÕÜØÙÝ, ÔèÙÝ)?( <textarea name="info" rows="5" cols="50"></textarea> <br></br> Ö. æÙÙß/Ù 5 ÞáÜÕÜÙÝ ÞâÜ 300 Þ' éØÙäáê (ÞÓÙàÔ, Ðêè, ÞáÜÕÜ, ÐÕèÚ ÑÞ', çÕéÙ, éàÔ): <br></br> 1. <input type="text" name="country" SIZE="10"> <input type="text" name="site" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 2. <input type="text" name="country" SIZE="10"> <input type="text" name="site" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 3. <input type="text" name="country" SIZE="10"> <input type="text" name="site" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 4. <input type="text" name="country" SIZE="10"> <input type="text" name="site" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 5. <input type="text" name="country" SIZE="10"> <input type="text" name="site" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> ×. æÙÙß/Ù 5 ÞáÜÕÜÙÝ ÞâÜ 6a (ÑÓèÕÒ æèäêÙ) éÔÕÑÜê âÜ ÐÑàÙ âÙÒÕß: <br></br> (ÞÓÙàÔ, Ðêè, ÞáÜÕÜ, ÐÕèÚ ÑÞ', çÕéÙ, éàÔ) <br></br> 1. <input type="text" name="country" SIZE="10"> <input type="text" name="site" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 2. <input type="text" name="country" SIZE="10"> <input type="text" name="site" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 3. <input type="text" name="country" SIZE="10"> <input type="text" name="site" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 4. <input type="text" name="country" SIZE="10"> <input type="text" name="site" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 5. <input type="text" name="country" SIZE="10"> <input type="text" name="site" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> Ø. æÙÙß/Ù 5 ÞáÜÕÜÙÝ ÐÜäÙàÙÙÙÝ, ÔÛÕÜÜÙÝ éÜÒ Õ/ÐÕ çè×, âÜ ÔÞáÜÕÜ ÐÕ ÑÐäèÕÐÕæ': <br></br> (ÞÓÙàÔ, èÛá, ÞáÜÕÜ, ÐÕèÚ ÑÞ', çÕéÙ, éàÔ) <br></br> 1. <input type="text" name="country" SIZE="10"> <input type="text" name="range" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 2. <input type="text" name="country" SIZE="10"> <input type="text" name="range" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 3. <input type="text" name="country" SIZE="10"> <input type="text" name="range" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 4. <input type="text" name="country" SIZE="10"> <input type="text" name="range" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> 5. <input type="text" name="country" SIZE="10"> <input type="text" name="range" SIZE="10"> <input type="text" name="route" SIZE="10"> <input type="text" name="length" SIZE="10"> <input type="text" name="diff" SIZE="10"> <input type="text" name="year" SIZE="10"> <br></br> Ù. æÙÙß/Ù 5 äáÒÕê âÜÙÔß ØÙäáê: <br></br> (èÛá, äáÒÔ, ÒÕÑÔ, áÒàÕß). <br></br> 1. <input type="text" name="range" SIZE="10"> <input type="text" name="summit" SIZE="10"> <input type="text" name="alt" SIZE="10"> <input type="text" name="style" SIZE="10"> <br></br> 2. <input type="text" name="range" SIZE="10"> <input type="text" name="summit" SIZE="10"> <input type="text" name="alt" SIZE="10"> <input type="text" name="style" SIZE="10"> <br></br> 3. <input type="text" name="range" SIZE="10"> <input type="text" name="summit" SIZE="10"> <input type="text" name="alt" SIZE="10"> <input type="text" name="style" SIZE="10"> <br></br> 4. <input type="text" name="range" SIZE="10"> <input type="text" name="summit" SIZE="10"> <input type="text" name="alt" SIZE="10"> <input type="text" name="style" SIZE="10"> <br></br> 5. <input type="text" name="range" SIZE="10"> <input type="text" name="summit" SIZE="10"> <input type="text" name="alt" SIZE="10"> <input type="text" name="style" SIZE="10"> <br></br> Ù"Ð. æÙÙß/Ù ÔÙéÒÙÝ àÕáäÙÝ éÔÙÕ ÜÚ ÑØÙäÕá: ÞáÜÕÜÙÝ ÞäÕèáÞÙÝ, ÔèÙÝ ÒÑÕÔÙÝ, ÞáÜÕÜÙÝ ÐèÕÛÙÝ, ÞäÜÙ çè×, áÕÜÕÐÙÝ ÕÛÕ'. <textarea name="info" rows="5" cols="50"></textarea> <br></br> <span style="font-weight: bold;">3. ÔéÛÜÔ ÕÔáÞÛÔ </span> <br></br> Ð. ÔéÛÜÔ <br></br> <input type="checkbox" name="hs" > êÙÛÕàÙê <input type="checkbox" name="col" >ÑÕÒè ÞÛÜÜÔ <input type="checkbox" name="grad" > ÐçÓÞÐÙ <input type="checkbox" name="higher" >êÐèÙÝ àÕáäÙÝ <input type="text" name="higher"> <br></br> Ñ. ÔáÞÛÕê Ñê×ÕÝ ÔØÙäÕá ÕÔÒÜÙéÔ ÑÐèå <br></br> <input type="checkbox" name="walls" >ÞäâÙÜ çÙèÕê ØÙäÕá <input type="checkbox" name="sport" >ÞÓèÙÚ ØÙäÕá áäÕèØÙÑÙ <input type="checkbox" name="rappel" >ÞÓèÙÚ ÒÜÙéÔ <input type="checkbox" name="climb" >ÞÓèÙÚ ØÙäÕá <input type="checkbox" name="omega" >ÑÕàÔ ÐÕÞÒÕê <input type="checkbox" name="high rappel" >ÞÓèÙÚ ÒÜÙéÔ ÑÛÙè <input type="checkbox" name="high climb" >ÞÓèÙÚ ØÙäÕá ÑÛÙè <input type="checkbox" name="coach" >ÞÐÞß <br></br> Ò. çÕèáÙÝ ÕÔáÞÛÕê Þ×Õ"Ü (äèØ Õæèã êâÕÓÔ, ÐÝ Ùé) <br></br> <textarea name="info" rows="5" cols="60"></textarea> <br></br> <span style="font-weight: bold;">4. çÕèÕê ×ÙÙÝ (ÑàÕéÐÙ ØÙäÕá) ÕäèØÙÝ àÕáäÙÝ èÜÕÕàØÙÙÝ </span> <br></br> <textarea name="info" rows="5" cols="60"></textarea> <br></br> <span style="font-weight: bold;">5. ÑçéÔ ÜÔæØèäÕê ÜâÞÕêÔ </span> <br></br> ÐàÙ (éÝ, Þâß ÕÞáäè ÖÔÕê)<input type="text" name="application" SIZE="50">, ÞÑçé ÜÔÙÕê ×Ñè ÑâÞÕêê ÞÓèÙÛÙ ÔØÙäÕá ÔÙéèÐÜÙÝ. ÞØèÕê ÔâÞÕêÔ ÕêçàÕàÔ ÙÓÕâÙÝ ÜÙ. ÐÝ ÐêçÑÜ Û×Ñè ÑÔ, ÐàÙ Þê×ÙÙÑ ÜçÙÙÝ Ðê ÔÕèÐÕê ÔêçàÕß ÕÐê Ô×ÜØÕê ÔÐáÙäÔ ÔÛÜÜÙê éÜ ÔâÞÕêÔ. <br></br> êÐèÙÚ <input type="text" name="date"> <br></br> </form> <br /><br /> </form> </body> </html>