<%@LANGUAGE="VBSCRIPT" CODEPAGE="1252"%> <% dim pos pos=InStr(Request.ServerVariables("HTTP_REFERER"),"teenpcar") IF pos=0 THEN response.redirect("http://www.teenpcar.org") end if %> <% ' Smart Mailer 1.0.7 ' Send on submit of form RYOT if Request.ServerVariables("REQUEST_METHOD") = "POST" then If request.form("address2") <> "" or request.form("address3") <> "catchspam" Then Response.redirect "ryotappication1.html" End IF If blnCAPTCHAcodeCorrect = False Then response.redirect("http://www.teenpcar.org/ryotapplication3.html") Else If blnCAPTCHAcodeCorrect = True Then Server.ScriptTimeout = 300 Set sm1 = new SmartMailer sm1.checkVersion "1.07" sm1.contentCharset = "us-ascii" Session.CodePage = sm1.getCodepage() sm1.smtpSetup "", "", "", "" sm1.pickup = "" sm1.component = "cdonts" sm1.tmpFolder = "" sm1.embedImages = false sm1.progressBar = "" sm1.ignore_errors = true sm1.useQueue = false sm1.setFrom "TeenPCAR", "information@teenpcar.com" sm1.setTo "TeenPCAR", "information@teenpcar.com" sm1.setCc "", "" sm1.setBcc "", "" sm1.Subject = "RYOT Application" ' using static for body sm1.setBody_Static_html "Name: " & (Request.Form("nameLast")) & "" & vbCRLF & "First Name: " & (Request.Form("nameFirst")) & "" & vbCRLF & "Birth Date: " & (Request.Form("birthDate")) & "" & vbCRLF & "Grade: " & (Request.Form("grade")) & "" & vbCRLF & "School: " & (Request.Form("school")) & "" & vbCRLF & "Mailing Address: " & (Request.Form("address")) & "" & vbCRLF & "City: " & (Request.Form("city")) & "" & vbCRLF & "Zip: " & (Request.Form("zip")) & "" & vbCRLF & "Phone: " & (Request.Form("phone")) & "" & vbCRLF & "Email Address: " & (Request.Form("email")) & "" & vbCRLF & "Leave phone message: " & (Request.Form("message")) & "" & vbCRLF & "Receive mail: " & (Request.Form("mail")) & "" & vbCRLF & "Why do you want to join: " & (Request.Form("why")) & "" & vbCRLF & "What will you contribute: " & (Request.Form("contribute")) & "" & vbCRLF & "" ' Attachments none sm1.sendMail "one" Response.Redirect "ryotappication2.html" end if SM_mailAction = getMailAction() end if end if %> Teen PCAR

 
RYOT (Rallying Youth Organizers Together) Against Rape is a network of teens formed by the Pennsylvania Coalition Against Rape (PCAR). RYOT Against Rape members are non-offending high school students - in grades 9 thru 12 - that work with local rape crisis centers to promote understanding of rights in relationships and to stop sexual violence. RYOT Against Rape members are invited to attend quarterly statewide meetings to create projects by teens for teens and also to offer insight into PCAR’s educational campaigns to prevent sexual violence against and by teens.

Please complete and submit this application form to become a member of RYOT Against Rape.
(You will be contacted by one or our representatives)
 

Last Name:
First Name:
Birth Date:
Grade:
Name of School:
Mailing Address:
City:
Zip:
Phone Number:
E-mail Address:
Is it okay to leave you a phone message from RYOT? Yes No
Is it okay for you to receive mail from RYOT and PCAR? Yes No
Why do you want to join RYOT Against Rape?
What interest, experiences or skills will you contribute to RYOT Against Rape?
Enter the code exactly as you see it in the image:- (Cookies must be enabled)
   


Questions or Comments?
Danielle Sunday Mitru Ciarlante
(800) 692-7445 ext. 144 (610) 657-1542
dsunday@pcar.org or act4change@comcast.net