{literal}
<form method="POST" name="FrontPage_Form1" action="freequote.php" onsubmit="return FrontPage_Form1_Validator(this)" language="JavaScript">
<div align="center">
<center>
<table border="0" cellpadding="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" id="AutoNumber3">
<tr>
<td width="558" colspan="2">
Contact Information:</td>
</tr>
<tr>
<td width="558" colspan="2"></td>
</tr>
<tr>
<td width="94" align="right">
Name:</td>
<td width="464">
<input type="text" name="Name" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94" align="right">
Company:</td>
<td width="464">
<input type="text" name="Company" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94" align="right">
Title:</td>
<td width="464">
<input type="text" name="Title" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94" align="right">
Address:</td>
<td width="464">
<input type="text" name="Address1" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94" align="right">
Address:</td>
<td width="464">
<input type="text" name="Address2" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94" align="right">
Country:</td>
<td width="464">
<input type="text" name="Country" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94" align="right">
E-Mail:</td>
<td width="464">
<input type="text" name="email" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94" align="right">
Phone:</td>
<td width="464">
<input type="text" name="phone" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94" align="right">
Fax:</td>
<td width="464">
<input type="text" name="fax" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94" align="right">
URL:</td>
<td width="464">
<input type="text" name="url" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94"></td>
<td width="464"></td>
</tr>
<tr>
<td width="558" colspan="2">
Describe Your Company:</td>
</tr>
<tr>
<td width="94"></td>
<td width="464">
<textarea rows="4" name="Company_Description" cols="48" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></textarea></td>
</tr>
<tr>
<td width="94"></td>
<td width="464"></td>
</tr>
<tr>
<td width="558" colspan="2">
Target Audience Web Page Is Intended For:</td>
</tr>
<tr>
<td width="94"></td>
<td width="464">
<textarea rows="4" name="Intended_Audience" cols="48" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></textarea></td>
</tr>
<tr>
<td width="94"></td>
<td width="464"></td>
</tr>
<tr>
<td width="558" colspan="2">
When Does Your Site Need To Be Online?</td>
</tr>
<tr>
<td width="94"></td>
<td width="464">
<textarea rows="4" name="Time_To_Live" cols="48" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></textarea></td>
</tr>
<tr>
<td width="94"></td>
<td width="464"></td>
</tr>
<tr>
<td width="558" colspan="2">
Describe The Theme Of Your New Web Site:</td>
</tr>
<tr>
<td width="94"></td>
<td width="464">
<textarea rows="4" name="Site_Theme" cols="48" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></textarea></td>
</tr>
<tr>
<td width="94"></td>
<td width="464"></td>
</tr>
<tr>
<td width="558" colspan="2">
Based On The Given Examples, Choose One
Which Best Will Resemble Your Site:</td>
</tr>
<tr>
<td width="94"></td>
<td width="464"></td>
</tr>
<tr>
<td width="94">Personal:</td>
<td width="464"><input type="radio" value="Personal" name="Choose_Site">Few
Graphics, Little Interactivity, 1-10 Pages</td>
</tr>
<tr>
<td width="94">Small Business:</td>
<td width="464">
<input type="radio" value="Small_Business" name="Choose_Site">Custom
Graphics, Forms, Moderate Interactivity, 10-20 Pages</td>
</tr>
<tr>
<td width="94">Large Business:</td>
<td width="464">
<input type="radio" value="Large_Business" name="Choose_Site">Detailed
Graphics, Shopping Cart, Java Applets, 10-20+ Pages</td>
</tr>
<tr>
<td width="94">Corporate:</td>
<td width="464">
<input type="radio" value="Corporate" checked name="Choose_Site">Detailed
Graphics, Dynamic Data, Interactive Pages 20+ Pages</td>
</tr>
<tr>
<td width="94"></td>
<td width="464"></td>
</tr>
<tr>
<td width="558" colspan="2">
Please Provide A URL Of A Web Page
Similar To Yours:</td>
</tr>
<tr>
<td width="94"></td>
<td width="464">
<input type="text" name="Similar_Page" size="20" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></td>
</tr>
<tr>
<td width="94"></td>
<td width="464"></td>
</tr>
<tr>
<td width="558" colspan="2">
Please Provide Any Additional Information
You Feel Will Help Us With Your Quote:</td>
</tr>
<tr>
<td width="94"></td>
<td width="464">
<textarea rows="4" name="Additional_Information" cols="49" style="border-style: solid; border-width: 1; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></textarea></td>
</tr>
<tr>
<td width="94"></td>
<td width="464"></td>
</tr>
<tr>
<td width="94"></td>
<td width="464"></td>
</tr>
</table>
</center>
</div>
<p align="center"><input type="submit" value="Submit" name="B1"><input type="reset" value="Reset" name="B2"></p>
</form>
{/literal}