CALS e-directory Registration Form

Intro This little form is designed to let you add, change, or delete your details from the E-Mail Directory - a worldwide list of Christadelphians and their e-mail addresses. Those on the list receive news and announcements from the brotherhood from time to time.
The fields with red headings are required so please fill those in, for the rest, if there is anything you're not sure about then just ignore it.
About You
First Name:  
Surname:
Choices:
Ecclesia
Baptised:
Ecclesia:
Rec.bro. surname:
Fellowship:
Country:
Other country:
E-Mail

Your main E-Mail address (second address is optional).

1: Main e-mail
2: Optional e-mail
Web
Web: If you have a Web site you would like listed then type the address here:
1:
Notes
More Info:
Any other information that you think could be useful. Commonly used to say "I can forward mail to Bill" or to include a place of work/study, etc. There is a maximum of 63 characters on each line so that everything will fit into the directory and be readable across E-Mail.
Example
Here is a sample entry:
Brown, Phil [BC] Newquay , UK phil@tic-toc.co.uk 

This tells you my name, my Ecclesia, and country, along with my E-Mail address.
The letters to the right of my name mean:

B I have been Baptised.
C I belong to the Central fellowship. The alternatives are
cogAf / Central / Dawn / Isolation / Unamended / Old paths / Viner hall