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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=ISO-8859-1" />
<title></title>
<style type="text/css">
fieldset {
margin-bottom: 1em;
border: 1px solid #888;
border-right: 1px solid #666;
border-bottom: 1px solid #666;
}
</style>
</head>
<body>
<div id="container">
<div id="wrapper">
<div id="content">
<form id="form1" name="form1" method="post" action="/">
<fieldset>
<legend>Contact Information</legend>
<label for="fmtitle" accesskey="i">T<span class="akey">i</span>tle</label>
<select name="fmtitle" id="fmtitle">
<option value="ms">Ms.</option>
<option value="mrs">Mrs.</option>
<option value="miss">Miss</option>
<option value="mr">Mr.</option>
</select>
<label for="fmname" accesskey="n"><span class="akey">N</span>ame</label>
<input type="text" name="fmname" id="fmname" />
<label for="fmemail" accesskey="e"><span class="akey">E</span>mail</label>
<input type="text" name="fmemail" id="fmemail" />
</fieldset>
<fieldset>
<legend>Your Message</legend>
<label for="fmstate" accesskey="y">Subject</label>
<input type="text" name="fmcountry" id="fmcountry" />
<label for="fmmsg"><span class="akey">M</span>essage</label>
<textarea name="fmmsg" accesskey="m" id="fmmsg" rows="5" cols="14"></textarea>
</fieldset>
<input type="submit" name="submit" value="send" class="submit" />
</form>
</div>
</div>
</div>
</body>
</html>
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