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         <h1 class="title">Do your bit</h1>                                        <div class="" id="node-662">


  



  
    
  <div class="content">
    <p>I pledge to take the following actions so that I can live more sustainably:</p>
<form action="/pledge"  method="post" id="webform-client-form-662" class="webform-client-form" enctype="multipart/form-data">
<div><div class="webform-component-select" id="webform-component-1180188973"><div class="form-item">
 <label>1. Green electricity: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180188973][a) Switch to a “green” tariff, either with my current electricity supplier or with a new supplier]" id="edit-submitted-1180188973-a)-Switch-to-a-“green”-tariff,-either-with-my-current-electricity-supplier-or-with-a-new-supplier" value="a) Switch to a “green” tariff, either with my current electricity supplier or with a new supplier"   class="form-checkbox" /> a) Switch to a “green” tariff, either with my current electricity supplier or with a new supplier</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180188973][b) Switch to an electricity producer that supplies 100% green renewable electricity]" id="edit-submitted-1180188973-b)-Switch-to-an-electricity-producer-that-supplies-100%-green-renewable-electricity" value="b) Switch to an electricity producer that supplies 100% green renewable electricity"   class="form-checkbox" /> b) Switch to an electricity producer that supplies 100% green renewable electricity</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180188973][c) Generate my own energy through installing solar panels, a wind turbine etc]" id="edit-submitted-1180188973-c)-Generate-my-own-energy-through-installing-solar-panels,-a-wind-turbine-etc" value="c) Generate my own energy through installing solar panels, a wind turbine etc"   class="form-checkbox" /> c) Generate my own energy through installing solar panels, a wind turbine etc</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180539982"><div class="form-item">
 <label>2. Energy saving: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180539982][a) Turn off lights when leaving the room and not leave appliances on standby]" id="edit-submitted-1180539982-a)-Turn-off-lights-when-leaving-the-room-and-not-leave-appliances-on-standby" value="a) Turn off lights when leaving the room and not leave appliances on standby"   class="form-checkbox" /> a) Turn off lights when leaving the room and not leave appliances on standby</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180539982][b) Switch to using low energy light bulbs]" id="edit-submitted-1180539982-b)-Switch-to-using-low-energy-light-bulbs" value="b) Switch to using low energy light bulbs"   class="form-checkbox" /> b) Switch to using low energy light bulbs</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180539982][c) Draught proof windows and doors]" id="edit-submitted-1180539982-c)-Draught-proof-windows-and-doors" value="c) Draught proof windows and doors"   class="form-checkbox" /> c) Draught proof windows and doors</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180539982][d) Insulate hot water pipes and tanks]" id="edit-submitted-1180539982-d)-Insulate-hot-water-pipes-and-tanks" value="d) Insulate hot water pipes and tanks"   class="form-checkbox" /> d) Insulate hot water pipes and tanks</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180540317"><div class="form-item">
 <label>3. Household products: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540317][a) Buy eco friendly cleaning products]" id="edit-submitted-1180540317-a)-Buy-eco-friendly-cleaning-products" value="a) Buy eco friendly cleaning products"   class="form-checkbox" /> a) Buy eco friendly cleaning products</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540317][b) Make my own cleaning products from natural substances (e.g. Tea tree oil)]" id="edit-submitted-1180540317-b)-Make-my-own-cleaning-products-from-natural-substances-(e.g.-Tea-tree-oil)" value="b) Make my own cleaning products from natural substances (e.g. Tea tree oil)"   class="form-checkbox" /> b) Make my own cleaning products from natural substances (e.g. Tea tree oil)</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540317][c) Use real nappies or a combination of real nappies and disposables]" id="edit-submitted-1180540317-c)-Use-real-nappies-or-a-combination-of-real-nappies-and-disposables" value="c) Use real nappies or a combination of real nappies and disposables"   class="form-checkbox" /> c) Use real nappies or a combination of real nappies and disposables</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180540514"><div class="form-item">
 <label>4. Local and organic food: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540514][a) Buy more products from "non-chain" shops in my local community]" id="edit-submitted-1180540514-a)-Buy-more-products-from-"non-chain"-shops-in-my-local-community" value="a) Buy more products from "non-chain" shops in my local community"   class="form-checkbox" /> a) Buy more products from "non-chain" shops in my local community</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540514][b) Eat less animal products and research alternatives]" id="edit-submitted-1180540514-b)-Eat-less-animal-products-and-research-alternatives" value="b) Eat less animal products and research alternatives"   class="form-checkbox" /> b) Eat less animal products and research alternatives</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540514][c) Buy locally grown food where possible]" id="edit-submitted-1180540514-c)-Buy-locally-grown-food-where-possible" value="c) Buy locally grown food where possible"   class="form-checkbox" /> c) Buy locally grown food where possible</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540514][d) Join an organic box scheme]" id="edit-submitted-1180540514-d)-Join-an-organic-box-scheme" value="d) Join an organic box scheme"   class="form-checkbox" /> d) Join an organic box scheme</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540514][e) Look more closely at the food miles associated with my purchases]" id="edit-submitted-1180540514-e)-Look-more-closely-at-the-food-miles-associated-with-my-purchases" value="e) Look more closely at the food miles associated with my purchases"   class="form-checkbox" /> e) Look more closely at the food miles associated with my purchases</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180540584"><div class="form-item">
 <label>5. Ethical finance: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540584][a) Join a credit union]" id="edit-submitted-1180540584-a)-Join-a-credit-union" value="a) Join a credit union"   class="form-checkbox" /> a) Join a credit union</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540584][b) Switch my credit card to one that donates to charity, or donate any cashback to charity]" id="edit-submitted-1180540584-b)-Switch-my-credit-card-to-one-that-donates-to-charity,-or-donate-any-cashback-to-charity" value="b) Switch my credit card to one that donates to charity, or donate any cashback to charity"   class="form-checkbox" /> b) Switch my credit card to one that donates to charity, or donate any cashback to charity</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540584][c) Switch my stock market investments to an “Ethical Fund”]" id="edit-submitted-1180540584-c)-Switch-my-stock-market-investments-to-an-“Ethical-Fund”" value="c) Switch my stock market investments to an “Ethical Fund”"   class="form-checkbox" /> c) Switch my stock market investments to an “Ethical Fund”</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540584][d) Switch my bank account to a more "ethically focused" bank (e.g., Co-op, Triodos, mutual)]" id="edit-submitted-1180540584-d)-Switch-my-bank-account-to-a-more-"ethically-focused"-bank-(e.g.,-Co-op,-Triodos,-mutual)" value="d) Switch my bank account to a more "ethically focused" bank (e.g., Co-op, Triodos, mutual)"   class="form-checkbox" /> d) Switch my bank account to a more "ethically focused" bank (e.g., Co-op, Triodos, mutual)</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180540640"><div class="form-item">
 <label>6. Green transport: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540640][a) Use green transport (Bus, Tram, Train, Bike or Walk) to travel to and from work]" id="edit-submitted-1180540640-a)-Use-green-transport-(Bus,-Tram,-Train,-Bike-or-Walk)-to-travel-to-and-from-work" value="a) Use green transport (Bus, Tram, Train, Bike or Walk) to travel to and from work"   class="form-checkbox" /> a) Use green transport (Bus, Tram, Train, Bike or Walk) to travel to and from work</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540640][b) Reduce my shopping - associated car mileage]" id="edit-submitted-1180540640-b)-Reduce-my-shopping---associated-car-mileage" value="b) Reduce my shopping - associated car mileage"   class="form-checkbox" /> b) Reduce my shopping - associated car mileage</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540640][c) Arrange my car breakdown service through the Environmental Transport Association]" id="edit-submitted-1180540640-c)-Arrange-my-car-breakdown-service-through-the-Environmental-Transport-Association" value="c) Arrange my car breakdown service through the Environmental Transport Association"   class="form-checkbox" /> c) Arrange my car breakdown service through the Environmental Transport Association</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540640][d) Use car sharing for some journeys]" id="edit-submitted-1180540640-d)-Use-car-sharing-for-some-journeys" value="d) Use car sharing for some journeys"   class="form-checkbox" /> d) Use car sharing for some journeys</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180540704"><div class="form-item">
 <label>7. Green holidays: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540704][a) Lessen the environmental and social impact of my holidays by choosing an ‘Eco holiday’]" id="edit-submitted-1180540704-a)-Lessen-the-environmental-and-social-impact-of-my-holidays-by-choosing-an-‘Eco-holiday’" value="a) Lessen the environmental and social impact of my holidays by choosing an ‘Eco holiday’"   class="form-checkbox" /> a) Lessen the environmental and social impact of my holidays by choosing an ‘Eco holiday’</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540704][b) Limit my impact on the environment by not flying when another form of transport is viable]" id="edit-submitted-1180540704-b)-Limit-my-impact-on-the-environment-by-not-flying-when-another-form-of-transport-is-viable" value="b) Limit my impact on the environment by not flying when another form of transport is viable"   class="form-checkbox" /> b) Limit my impact on the environment by not flying when another form of transport is viable</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540704][c) Offset the CO2 emissions of my air travel]" id="edit-submitted-1180540704-c)-Offset-the-CO2-emissions-of-my-air-travel" value="c) Offset the CO2 emissions of my air travel"   class="form-checkbox" /> c) Offset the CO2 emissions of my air travel</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180540744"><div class="form-item">
 <label>8. Fair trade: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540744][a) Buy more Fair Trade products as part of my regular shopping]" id="edit-submitted-1180540744-a)-Buy-more-Fair-Trade-products-as-part-of-my-regular-shopping" value="a) Buy more Fair Trade products as part of my regular shopping"   class="form-checkbox" /> a) Buy more Fair Trade products as part of my regular shopping</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540744][b) Eat in restaurants and cafes that sell Fair Trade]" id="edit-submitted-1180540744-b)-Eat-in-restaurants-and-cafes-that-sell-Fair-Trade" value="b) Eat in restaurants and cafes that sell Fair Trade"   class="form-checkbox" /> b) Eat in restaurants and cafes that sell Fair Trade</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540744][c) Join my local Fair Trade group (contact AfSL for info)]" id="edit-submitted-1180540744-c)-Join-my-local-Fair-Trade-group-(contact-AfSL-for-info)" value="c) Join my local Fair Trade group (contact AfSL for info)"   class="form-checkbox" /> c) Join my local Fair Trade group (contact AfSL for info)</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180540785"><div class="form-item">
 <label>9. Save water: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540785][a) Use water from my bath/dishes, or collect rainwater in a “butt”, to water my plants or garden]" id="edit-submitted-1180540785-a)-Use-water-from-my-bath/dishes,-or-collect-rainwater-in-a-“butt”,-to-water-my-plants-or-garden" value="a) Use water from my bath/dishes, or collect rainwater in a “butt”, to water my plants or garden"   class="form-checkbox" /> a) Use water from my bath/dishes, or collect rainwater in a “butt”, to water my plants or garden</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540785][b) Reduce the amount of water used to flush the toilet by using a “water-save cistern filler”]" id="edit-submitted-1180540785-b)-Reduce-the-amount-of-water-used-to-flush-the-toilet-by-using-a-“water-save-cistern-filler”" value="b) Reduce the amount of water used to flush the toilet by using a “water-save cistern filler”"   class="form-checkbox" /> b) Reduce the amount of water used to flush the toilet by using a “water-save cistern filler”</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540785][c) Install a water meter]" id="edit-submitted-1180540785-c)-Install-a-water-meter" value="c) Install a water meter"   class="form-checkbox" /> c) Install a water meter</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180540827"><div class="form-item">
 <label>10. Recycling: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540827][a) Reuse plastic bags and think of other ways to reuse waste]" id="edit-submitted-1180540827-a)-Reuse-plastic-bags-and-think-of-other-ways-to-reuse-waste" value="a) Reuse plastic bags and think of other ways to reuse waste"   class="form-checkbox" /> a) Reuse plastic bags and think of other ways to reuse waste</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540827][b) Use rechargeable batteries]" id="edit-submitted-1180540827-b)-Use-rechargeable-batteries" value="b) Use rechargeable batteries"   class="form-checkbox" /> b) Use rechargeable batteries</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540827][c) Not buy pre packed food or products with excessive packaging]" id="edit-submitted-1180540827-c)-Not-buy-pre-packed-food-or-products-with-excessive-packaging" value="c) Not buy pre packed food or products with excessive packaging"   class="form-checkbox" /> c) Not buy pre packed food or products with excessive packaging</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540827][d) Recycle waste where possible, making full use of the council's doorstep recycling scheme]" id="edit-submitted-1180540827-d)-Recycle-waste-where-possible,-making-full-use-of-the-council's-doorstep-recycling-scheme" value="d) Recycle waste where possible, making full use of the council's doorstep recycling scheme"   class="form-checkbox" /> d) Recycle waste where possible, making full use of the council's doorstep recycling scheme</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180540864"><div class="form-item">
 <label>11. Organic gardening and composting: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540864][a) Compost my biodegradable waste]" id="edit-submitted-1180540864-a)-Compost-my-biodegradable-waste" value="a) Compost my biodegradable waste"   class="form-checkbox" /> a) Compost my biodegradable waste</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540864][b) Grow my own fruit and vegetables]" id="edit-submitted-1180540864-b)-Grow-my-own-fruit-and-vegetables" value="b) Grow my own fruit and vegetables"   class="form-checkbox" /> b) Grow my own fruit and vegetables</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540864][c) Use natural fertilizers and pest control]" id="edit-submitted-1180540864-c)-Use-natural-fertilizers-and-pest-control" value="c) Use natural fertilizers and pest control"   class="form-checkbox" /> c) Use natural fertilizers and pest control</label>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1180540901"><div class="form-item">
 <label>12. Ethical clothing: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540901][a) As my children grow out of clothes, pass them on to younger children]" id="edit-submitted-1180540901-a)-As-my-children-grow-out-of-clothes,-pass-them-on-to-younger-children" value="a) As my children grow out of clothes, pass them on to younger children"   class="form-checkbox" /> a) As my children grow out of clothes, pass them on to younger children</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540901][b) Take all my unwanted clothes to charity shops]" id="edit-submitted-1180540901-b)-Take-all-my-unwanted-clothes-to-charity-shops" value="b) Take all my unwanted clothes to charity shops"   class="form-checkbox" /> b) Take all my unwanted clothes to charity shops</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540901][c) Buy clothes made from natural materials]" id="edit-submitted-1180540901-c)-Buy-clothes-made-from-natural-materials" value="c) Buy clothes made from natural materials"   class="form-checkbox" /> c) Buy clothes made from natural materials</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180540901][d) Buy my clothes from ethical trading companies or charity shops]" id="edit-submitted-1180540901-d)-Buy-my-clothes-from-ethical-trading-companies-or-charity-shops" value="d) Buy my clothes from ethical trading companies or charity shops"   class="form-checkbox" /> d) Buy my clothes from ethical trading companies or charity shops</label>
</div>
</div>
</div>
</div><div class="webform-component-textarea" id="webform-component-1180540974"><div class="form-item">
 <label for="edit-submitted-1180540974">Other pledges: </label>
 <textarea cols="70" rows="5" name="submitted[1180540974]" id="edit-submitted-1180540974"  class="form-textarea resizable"></textarea>
</div>
</div><div class="webform-component-textfield" id="webform-component-1180541014"><div class="form-item">
 <label for="edit-submitted-1180541014">First name: </label>
 <input type="text" maxlength="128" name="submitted[1180541014]" id="edit-submitted-1180541014"  size="60" value="" class="form-text" />
</div>
</div><div class="webform-component-textfield" id="webform-component-1180541030"><div class="form-item">
 <label for="edit-submitted-1180541030">Last name: </label>
 <input type="text" maxlength="128" name="submitted[1180541030]" id="edit-submitted-1180541030"  size="60" value="" class="form-text" />
</div>
</div><div class="webform-component-textarea" id="webform-component-1180541557"><div class="form-item">
 <label for="edit-submitted-1180541557">Address: </label>
 <textarea cols="70" rows="5" name="submitted[1180541557]" id="edit-submitted-1180541557"  class="form-textarea resizable"></textarea>
</div>
</div><div class="webform-component-textfield" id="webform-component-1180541589"><div class="form-item">
 <label for="edit-submitted-1180541589">Postcode: </label>
 <input type="text" maxlength="10" name="submitted[1180541589]" id="edit-submitted-1180541589"  size="10" value="" class="form-text" />
</div>
</div><div class="webform-component-textfield" id="webform-component-1180541662"><div class="form-item">
 <label for="edit-submitted-1180541662">Telephone: </label>
 <input type="text" maxlength="17" name="submitted[1180541662]" id="edit-submitted-1180541662"  size="17" value="" class="form-text" />
</div>
</div><div class="webform-component-email" id="webform-component-1180186860"><div class="form-item">
 <label for="edit-submitted-1180186860">Email: </label>
 <input type="text" maxlength="128" name="submitted[1180186860]" id="edit-submitted-1180186860"  size="50" value="" class="form-text" />
 <div class="description"><p>Your email address</p>
</div>
</div>
</div><fieldset class="webform-component-fieldset" id="webform-component-1207080381"><legend>About me</legend><div class="description"><p>Please answer these questions to help us assess the impact of our work, better target our efforts and make a stronger case to funders</p>
</div><div class="webform-component-select" id="webform-component-1194475087"><div class="form-item">
 <label for="edit-submitted-1207080381-1194475087">Gender: </label>
 <select name="submitted[1207080381][1194475087]" class="form-select" id="edit-submitted-1207080381-1194475087" ><option value="" selected="selected">select...</option><option value="Female">Female</option><option value="Male">Male</option><option value="Other">Other</option></select>
</div>
</div><div class="webform-component-textfield" id="webform-component-1194475458"><div class="form-item">
 <label for="edit-submitted-1207080381-1194475458">Age: </label>
 <input type="text" maxlength="2" name="submitted[1207080381][1194475458]" id="edit-submitted-1207080381-1194475458"  size="2" value="" class="form-text" />
</div>
</div><div class="webform-component-select" id="webform-component-1207081154"><div class="form-item">
 <label for="edit-submitted-1207080381-1207081154">Current lifestyle: </label>
 <select name="submitted[1207080381][1207081154]" class="form-select" id="edit-submitted-1207080381-1207081154" ><option value="" selected="selected">select...</option><option value="I don’t really do anything that is environmentally-friendly">I don’t really do anything that is environmentally-friendly</option><option value="I do one or two things that are environmentally-friendly">I do one or two things that are environmentally-friendly</option><option value="I do quite a few things that are environmentally-friendly">I do quite a few things that are environmentally-friendly</option><option value="I’m environmentally-friendly in most things I do">I’m environmentally-friendly in most things I do</option><option value="I’m environmentally-friendly in everything I do">I’m environmentally-friendly in everything I do</option><option value="Don&#039;t know">Don&#039;t know</option></select>
</div>
</div></fieldset>
<div class="webform-component-select" id="webform-component-1180541889"><div class="form-item">
 <label>Further contact: </label>
 <div class="form-checkboxes"><div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180541889][I would not like to be contacted by AfSL to find out how I am getting on with my pledges]" id="edit-submitted-1180541889-I-would-not-like-to-be-contacted-by-AfSL-to-find-out-how-I-am-getting-on-with-my-pledges" value="I would not like to be contacted by AfSL to find out how I am getting on with my pledges"   class="form-checkbox" /> I would not like to be contacted by AfSL to find out how I am getting on with my pledges</label>
</div>
<div class="form-item">
 <label class="option"><input type="checkbox" name="submitted[1180541889][I would not like to receive AfSL's free e-newsletter]" id="edit-submitted-1180541889-I-would-not-like-to-receive-AfSL's-free-e-newsletter" value="I would not like to receive AfSL's free e-newsletter"   class="form-checkbox" /> I would not like to receive AfSL's free e-newsletter</label>
</div>
</div>
 <div class="description"><p>Tick these boxes if you do not wish to be contacted by AfSL in the future</p>
</div>
</div>
</div><fieldset class="webform-component-fieldset collapsible collapsed" id="webform-component-1194473546"><legend>AfSL use only</legend><input type="hidden" name="submitted[1194473546][1180187640]" id="edit-submitted-1194473546-1180187640" value="Tuesday, 7. February 2012 - 10:00"  />
<div class="webform-component-date" id="webform-component-1194473598"><div class="form-item">
 <label for="edit-submitted-1194473546-1194473598">Date of pledge: </label>
 <div class="container-inline"><div class="form-item">
 <select name="submitted[1194473546][1194473598][day]" class="form-select" id="edit-submitted-1194473546-1194473598-day" ><option value="">Day</option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7" selected="selected">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>
</div>
<div class="form-item">
 <select name="submitted[1194473546][1194473598][month]" class="form-select" id="edit-submitted-1194473546-1194473598-month" ><option value="">Month</option><option value="1">Jan</option><option value="2" selected="selected">Feb</option><option value="3">Mar</option><option value="4">Apr</option><option value="5">May</option><option value="6">Jun</option><option value="7">Jul</option><option value="8">Aug</option><option value="9">Sep</option><option value="10">Oct</option><option value="11">Nov</option><option value="12">Dec</option></select>
</div>
<div class="form-item">
 <select name="submitted[1194473546][1194473598][year]" class="form-select" id="edit-submitted-1194473546-1194473598-year" ><option value="">Year</option><option value="1900">1900</option><option value="1901">1901</option><option value="1902">1902</option><option value="1903">1903</option><option value="1904">1904</option><option value="1905">1905</option><option value="1906">1906</option><option value="1907">1907</option><option value="1908">1908</option><option value="1909">1909</option><option value="1910">1910</option><option value="1911">1911</option><option value="1912">1912</option><option value="1913">1913</option><option value="1914">1914</option><option value="1915">1915</option><option value="1916">1916</option><option value="1917">1917</option><option value="1918">1918</option><option value="1919">1919</option><option value="1920">1920</option><option value="1921">1921</option><option value="1922">1922</option><option value="1923">1923</option><option value="1924">1924</option><option value="1925">1925</option><option value="1926">1926</option><option value="1927">1927</option><option value="1928">1928</option><option value="1929">1929</option><option value="1930">1930</option><option value="1931">1931</option><option value="1932">1932</option><option value="1933">1933</option><option value="1934">1934</option><option value="1935">1935</option><option value="1936">1936</option><option value="1937">1937</option><option value="1938">1938</option><option value="1939">1939</option><option value="1940">1940</option><option value="1941">1941</option><option value="1942">1942</option><option value="1943">1943</option><option value="1944">1944</option><option value="1945">1945</option><option value="1946">1946</option><option value="1947">1947</option><option value="1948">1948</option><option value="1949">1949</option><option value="1950">1950</option><option value="1951">1951</option><option value="1952">1952</option><option value="1953">1953</option><option value="1954">1954</option><option value="1955">1955</option><option value="1956">1956</option><option value="1957">1957</option><option value="1958">1958</option><option value="1959">1959</option><option value="1960">1960</option><option value="1961">1961</option><option value="1962">1962</option><option value="1963">1963</option><option value="1964">1964</option><option value="1965">1965</option><option value="1966">1966</option><option value="1967">1967</option><option value="1968">1968</option><option value="1969">1969</option><option value="1970">1970</option><option value="1971">1971</option><option value="1972">1972</option><option value="1973">1973</option><option value="1974">1974</option><option value="1975">1975</option><option value="1976">1976</option><option value="1977">1977</option><option value="1978">1978</option><option value="1979">1979</option><option value="1980">1980</option><option value="1981">1981</option><option value="1982">1982</option><option value="1983">1983</option><option value="1984">1984</option><option value="1985">1985</option><option value="1986">1986</option><option value="1987">1987</option><option value="1988">1988</option><option value="1989">1989</option><option value="1990">1990</option><option value="1991">1991</option><option value="1992">1992</option><option value="1993">1993</option><option value="1994">1994</option><option value="1995">1995</option><option value="1996">1996</option><option value="1997">1997</option><option value="1998">1998</option><option value="1999">1999</option><option value="2000">2000</option><option value="2001">2001</option><option value="2002">2002</option><option value="2003">2003</option><option value="2004">2004</option><option value="2005">2005</option><option value="2006">2006</option><option value="2007">2007</option><option value="2008">2008</option><option value="2009">2009</option><option value="2010">2010</option><option value="2011">2011</option><option value="2012" selected="selected">2012</option><option value="2013">2013</option><option value="2014">2014</option><option value="2015">2015</option><option value="2016">2016</option><option value="2017">2017</option><option value="2018">2018</option><option value="2019">2019</option><option value="2020">2020</option><option value="2021">2021</option><option value="2022">2022</option><option value="2023">2023</option><option value="2024">2024</option><option value="2025">2025</option><option value="2026">2026</option><option value="2027">2027</option><option value="2028">2028</option><option value="2029">2029</option><option value="2030">2030</option><option value="2031">2031</option><option value="2032">2032</option><option value="2033">2033</option><option value="2034">2034</option><option value="2035">2035</option><option value="2036">2036</option><option value="2037">2037</option><option value="2038">2038</option><option value="2039">2039</option><option value="2040">2040</option><option value="2041">2041</option><option value="2042">2042</option><option value="2043">2043</option><option value="2044">2044</option><option value="2045">2045</option><option value="2046">2046</option><option value="2047">2047</option><option value="2048">2048</option><option value="2049">2049</option><option value="2050">2050</option></select>
</div>
</div>
</div>
</div><div class="webform-component-select" id="webform-component-1194473906"><div class="form-item">
 <label for="edit-submitted-1194473546-1194473906">Mode of contact: </label>
 <select name="submitted[1194473546][1194473906]" class="form-select" id="edit-submitted-1194473546-1194473906" ><option value="" selected="selected">select...</option><option value="Phone">Phone</option><option value="Email">Email</option><option value="Website">Website</option><option value="Face-to-face: one-to-one">Face-to-face: one-to-one</option><option value="Face-to-face: group session/workshop">Face-to-face: group session/workshop</option><option value="Other">Other</option></select>
</div>
</div><div class="webform-component-select" id="webform-component-1194474145"><div class="form-item">
 <label for="edit-submitted-1194473546-1194474145">Level of input: </label>
 <select name="submitted[1194473546][1194474145]" class="form-select" id="edit-submitted-1194473546-1194474145" ><option value="" selected="selected">select...</option><option value="Mini consultation">Mini consultation</option><option value="Full consultation">Full consultation</option><option value="Pledges without consultation">Pledges without consultation</option><option value="Other">Other</option></select>
</div>
</div><div class="webform-component-textfield" id="webform-component-1194474355"><div class="form-item">
 <label for="edit-submitted-1194473546-1194474355">Duration of contact (minutes): </label>
 <input type="text" maxlength="3" name="submitted[1194473546][1194474355]" id="edit-submitted-1194473546-1194474355"  size="3" value="" class="form-text" />
</div>
</div><div class="webform-component-textarea" id="webform-component-1194475575"><div class="form-item">
 <label for="edit-submitted-1194473546-1194475575">Notes: </label>
 <textarea cols="100" rows="5" name="submitted[1194473546][1194475575]" id="edit-submitted-1194473546-1194475575"  class="form-textarea resizable"></textarea>
</div>
</div><div class="webform-component-select" id="webform-component-1194475678"><div class="form-item">
 <label for="edit-submitted-1194473546-1194475678">Pledge collected by: </label>
 <select name="submitted[1194473546][1194475678]" class="form-select" id="edit-submitted-1194473546-1194475678" ><option value="" selected="selected">select...</option><option value="Louise Allen">Louise Allen</option><option value="Natalie Barugh">Natalie Barugh</option><option value="Roisin Bond">Roisin Bond</option><option value="Caroline Bowers">Caroline Bowers</option><option value="Annabel Bradbury">Annabel Bradbury</option><option value="Jess Buck">Jess Buck</option><option value="Andrew Chinuck">Andrew Chinuck</option><option value="Sally Cott">Sally Cott</option><option value="Peter Crookell">Peter Crookell</option><option value="Claire d&#039;Ambra">Claire d&#039;Ambra</option><option value="Laura Fenton">Laura Fenton</option><option value="Lyn Gilpin">Lyn Gilpin</option><option value="Joanne Leach">Joanne Leach</option><option value="Phil Long">Phil Long</option><option value="Ali Muhammad">Ali Muhammad</option><option value="Xing Nie">Xing Nie</option><option value="Odette O’Reilly">Odette O’Reilly</option><option value="Kate Shalabanova">Kate Shalabanova</option><option value="Emma Sheppard">Emma Sheppard</option><option value="Emma Smail">Emma Smail</option><option value="Helen Starr-Keddle">Helen Starr-Keddle</option><option value="Josh Steiner">Josh Steiner</option><option value="James Wibberley">James Wibberley</option><option value="Other (please state in notes)">Other (please state in notes)</option></select>
</div>
</div><div class="webform-component-select" id="webform-component-1194476015"><div class="form-item">
 <label for="edit-submitted-1194473546-1194476015">Data keyed in by: </label>
 <select name="submitted[1194473546][1194476015]" class="form-select" id="edit-submitted-1194473546-1194476015" ><option value="" selected="selected">select...</option><option value="Louise Allen">Louise Allen</option><option value="Natalie Barugh">Natalie Barugh</option><option value="Roisin Bond">Roisin Bond</option><option value="Caroline Bowers">Caroline Bowers</option><option value="Annabel Bradbury">Annabel Bradbury</option><option value="Jess Buck">Jess Buck</option><option value="Andrew Chinuck">Andrew Chinuck</option><option value="Sally Cott">Sally Cott</option><option value="Peter Crookell">Peter Crookell</option><option value="Claire d&#039;Ambra">Claire d&#039;Ambra</option><option value="Laura Fenton">Laura Fenton</option><option value="Lyn Gilpin">Lyn Gilpin</option><option value="Joanne Leach">Joanne Leach</option><option value="Phil Long">Phil Long</option><option value="Ali Muhammad">Ali Muhammad</option><option value="Xing Nie">Xing Nie</option><option value="Odette O’Reilly">Odette O’Reilly</option><option value="Donna Scarth">Donna Scarth</option><option value="Kate Shalabanova">Kate Shalabanova</option><option value="Emma Sheppard">Emma Sheppard</option><option value="Emma Smail">Emma Smail</option><option value="Helen Starr-Keddle">Helen Starr-Keddle</option><option value="Josh Steiner">Josh Steiner</option><option value="James Wibberley">James Wibberley</option><option value="Other (please state in notes)">Other (please state in notes)</option></select>
</div>
</div></fieldset>
<input type="hidden" name="details[email_subject]" id="edit-details-email-subject" value="default"  />
<input type="hidden" name="details[email_from_name]" id="edit-details-email-from-name" value="default"  />
<input type="hidden" name="details[email_from_address]" id="edit-details-email-from-address" value="1"  />
<input type="hidden" name="form_id" id="edit-webform-client-form-662" value="webform_client_form_662"  />
<fieldset class="captcha"><legend>CAPTCHA</legend><div class="description">This question is for testing whether you are a human visitor and to prevent automated spam submissions.</div><img src="/image_captcha/1168506938" alt="Image CAPTCHA" title="Image CAPTCHA" /><div class="form-item">
 <label for="edit-captcha-response">What code is in the image?: <span class="form-required" title="This field is required.">*</span></label>
 <input type="text" maxlength="128" name="captcha_response" id="edit-captcha-response"  size="15" value="" class="form-text required" />
 <div class="description">Copy the characters (respecting upper/lower case) from the image.</div>
</div>
<input type="hidden" name="captcha_token" id="edit-captcha-token" value="a301e07daa25ccb15c748dcae2427e57"  />
</fieldset>
<input type="submit" name="op" id="edit-submit" value="Submit"  class="form-submit" />

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  <div class="sidec"><div class='view view-volunteer-opportunities'><div class='view-content view-content-volunteer-opportunities'><div class="item-list"><ul><li><div class='view-item view-item-volunteer-opportunities'><div class='view-field view-data-node-title'><a href="/timperley-recruitment">Timperley Eco Community Volunteers</a></div></div>
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