File: /home/design11/hotbeveragenutrition.com/contact.html
<!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>
<title>Feedback Form</title>
<style type="text/css">
<!--
.text {
font-family: "Arial Black", Gadget, sans-serif;
font-size: large;
}
.text {
font-family: Arial, Helvetica, sans-serif;
}
-->
</style>
</head>
<body>
<span class="text">Contact Us</span>
<form action="http://www.hotbeveragenutrition.com/formtools/process.php" method="post">
<input type="hidden" name="form_tools_form_id" value="1" /><table>
<tr>
<td>Name</td>
<td><input type="text" name="name" value="" maxlength="100" /></td>
</tr>
<tr>
<td>Email Adress:</td>
<td>
<input type="text" name="email_address" value="" maxlength="100" />
</td>
</tr>
<tr>
<td>Comments:</td>
<td>
<textarea rows="10" cols="50" name="comments"></textarea>
</td>
</tr>
<tr>
<td> </td>
<td>
<input type="submit" value="Submit" />
</td>
</tr>
</table>
</form>
<p> </p>
</body>
</html>