<?xml version="1.0" encoding="UTF-8"?>

<form url="personalized_ebook.php"
 window="_self"
 method="POST"
 fontname="MS Sans Serif"
 width="625"
 height="675"
 bkcolor="0xF3FFE8"
 transparent="f"
 fontcolor="0x000000"
 outlinecolor="0xFFFFFF"
 themecolor="0xFFFF99"
 fontcolor2="#000000"
 bkcolor2="#FFFFFF"
 includeresults="false"
 emailuser="true"
 verifymessage="The E-Mail address you entered does not match !"
 reqmessage="One or More Fields are Required !"
 invalidemailmsg="is an invalid address, please correct it."
 transition="0"
 autoresponseincluderesults="f"
 autoresponseaddtotop="f"
 usephp="true"
 disableclicktoactiveprompt="true"
 extensions="*.txt;*.gif;*.jpg;*.jpeg;*.zip;*.doc;*.png;*.pdf;*.rtf;*.html;*.docx;*.xslx"
>

<hidden
 name="thankyoupage"
 value="http://phaselockmaster.com/support/form_submission_02.htm"
></hidden>

<hidden
 name="subject"
 value=""
></hidden>

<image
 image="girl_prett_support_02.jpg"
 x="130"
 y="500"
></image>

<textinput
 name="Name"
 x="129"
 y="100"
 w="390"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<submitbutton
 name="Reset Button"
 x="415"
 y="622"
 w="89"
 h="27"
 label="Submit"
 fontname="Arial"
 fontcolor="0x000000"
 image="submit-grey.png"
  fontsize="12"
></submitbutton>

<combobox
 name="My Drop-Down 1"
 x="130"
 y="300"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 isemail="false"
 w="137"
 h="20">
  <item name="None...."></item>
  <item name="General Question?"></item>
  <item name="Access Question?"></item>
  <item name="Website Template Question?"></item>
  <item name="Auction Template Question?"></item>
  <item name="Payment Question?"></item>
  <item name="eBook Question?"></item>
  <item name=""></item>
  <item name=""></item>
</combobox>

<textinput
 name="E-MAIL"
 x="128"
 y="137"
 w="391"
 h="22"
 initvalue=""
 maxchars="50"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 emailbox="true"
 editable="true"
  restrict="email"
>
</textinput>

<textarea
 name="Message"
 x="130"
 y="370"
 w="389"
 h="118"
 initvalue=""
 wordwrap="true"
 editable="true"
 bkcolor="0xFFFFFF"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></textarea>

<textinput
 name="gogo20 Username"
 x="181"
 y="176"
 w="338"
 h="22"
 initvalue=""
 maxchars="40"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
 editable="true"
>
</textinput>

<label
 name="My Text 2"
 x="50"
 y="100"
 w="41"
 h="16"
 text="Name"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x6B7171"
  fontsize="13"
></label>

<label
 name="My Text 3"
 x="50"
 y="140"
 w="44"
 h="16"
 text="E-mail"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x6B7171"
  fontsize="13"
></label>

<label
 name="My Text 4"
 x="50"
 y="301"
 w="60"
 h="16"
 text="Question"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x6B7171"
  fontsize="13"
></label>

<label
 name="My Text 1"
 x="118"
 y="14"
 w="412"
 h="29"
 text="Personalize eBook Request Form"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x3C312F"
  fontsize="23"
></label>

<label
 name="My Text 8"
 x="50"
 y="365"
 w="59"
 h="16"
 text="Message"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x6B7171"
  fontsize="13"
></label>

<captcha
 name="My Captcha 1"
 x="390"
 y="500"
 w="133"
 h="100"
 text="Enter Key Here:"
 fnt="Arial"
 fntclr="0x000000"
 fntsize="11"
 bkbdrcolor="0x000000"
 bkfillclr="0xFFFFFF"
 bkdobdr="t"
 bkbdrsolid="t"
 bkdobk="t"
 bkfillalpha="100"
 message="Incorrect key!"
></captcha>

<label
 name="My Text 5"
 x="122"
 y="48"
 w="403"
 h="16"
 text="Please complete the form below to receive your gogo20 eBook"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x6B7171"
  fontsize="13"
></label>

<label
 name="My Text 6"
 x="50"
 y="180"
 w="122"
 h="16"
 text="gogo20 Username:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x6B7171"
  fontsize="13"
></label>

<label
 name="My Text 7"
 x="150"
 y="238"
 w="343"
 h="19"
 text="Have any additional Questions or Problems?"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="16"
></label>

<label
 name="My Text 9"
 x="150"
 y="260"
 w="339"
 h="14"
 text="Please allow 24-48 hours to receive your personalized eBook"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x808080"
  fontsize="11"
></label>

</form>
