10 |
</td> |
</td> |
11 |
</tr> |
</tr> |
12 |
<tr> |
<tr> |
13 |
<td valign=center align=left>Full Name</td> |
<td valign=center align=left>{rinput name=fullname desc="Full Name"}</td> |
14 |
<td valign=center align=left> |
<td valign=center align=left> |
15 |
<input size=22 name=fullname> |
{input size=22 name=fullname} |
16 |
</td> |
</td> |
17 |
</tr> |
</tr> |
18 |
<tr> |
<tr> |
19 |
<td valign=center align=left> |
<td valign=center align=left> |
20 |
<div align="left">Email</div> |
<div align="left">{rinput name=mailfrom desc="Email"}</div> |
21 |
</td> |
</td> |
22 |
<td valign=center align=left> |
<td valign=center align=left> |
23 |
<input size=22 name=mailfrom> |
{input size=22 name=mailfrom type=email} |
24 |
</td> |
</td> |
25 |
</tr> |
</tr> |
26 |
<tr> |
<tr> |
38 |
</tr> |
</tr> |
39 |
<tr> |
<tr> |
40 |
<td valign=center align=left> |
<td valign=center align=left> |
41 |
<div align="left">Subject</div> |
<div align="left">{rinput name=subject desc="Subject"}</div> |
42 |
</td> |
</td> |
43 |
<td valign=center align=left> |
<td valign=center align=left> |
44 |
<input size=22 name=subject> |
{input size=22 name=subject} |
45 |
</td> |
</td> |
46 |
</tr> |
</tr> |
47 |
<tr> |
<tr> |
48 |
<td valign=center align=left colspan=2> |
<td valign=center align=left colspan=2> |
49 |
<p>Please leave your comments below:</p> |
<br>Please leave your comments below:<br> |
|
<p> |
|
50 |
<textarea name=comment rows=5 cols=35></textarea> |
<textarea name=comment rows=5 cols=35></textarea> |
51 |
</p> |
<br><br>All fields in <b>bold</b> are required |
52 |
<input type=submit value=Submit name="submit"> |
<input type=submit value=Submit name="submit"> |
|
|
|
53 |
<input type=reset value=Reset name="reset"></form> |
<input type=reset value=Reset name="reset"></form> |
54 |
</td> |
</td> |
55 |
</tr> |
</tr> |