<?xml version="1.0" encoding="UTF-8"?>

<form url="submit_form.php"
 window="_self"
 method="POST"
 fontname="MS Sans Serif"
 width="360"
 height="534"
 bkcolor="0xFFFFFF"
 transparent="f"
 fontcolor="0x000000"
 outlinecolor="0x000000"
 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"
 transition="0"
 autoresponseincluderesults="f"
 autoresponseaddtotop="f"
 usephp="true"
 disableclicktoactiveprompt="true"
 extensions="*.txt;*.gif;*.jpg;*.jpeg;*.zip;*.doc;*.png;*.pdf;*.rtf"
>

<hidden
 name="subject"
 value="My Contact Form"
></hidden>

<image
 image="pencil-logo.jpg"
 x="218"
 y="3"
></image>

<textinput
 name="My Input Box 1"
 x="12"
 y="29"
 w="175"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
 editable="true"
>
</textinput>

<textinput
 name="My Input Box 2"
 x="8"
 y="92"
 w="175"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
 emailbox="true"
 editable="true"
  restrict="email"
>
</textinput>

<textarea
 name="My Text Area 1"
 x="12"
 y="276"
 w="314"
 h="91"
 initvalue=""
 wordwrap="true"
 editable="true"
 bkcolor="0xFFFFFF"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></textarea>

<submitbutton
 name="Submit Button"
 x="76"
 y="492"
 w="185"
 h="20"
 label="Send My Message"
 fontname="Georgia"
 fontcolor="0x800000"
  fontsize="12"
></submitbutton>

<label
 name="My Text 1"
 x="12"
 y="256"
 w="87"
 h="16"
 text="comments:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x993300"
  fontsize="13"
></label>

<label
 name="My Text 2"
 x="8"
 y="152"
 w="317"
 h="16"
 text="how would you like to receive  my system*?"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 3"
 x="12"
 y="72"
 w="157"
 h="16"
 text="Your E-Mail Address:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 4"
 x="12"
 y="11"
 w="131"
 h="16"
 text="Your First  Name:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x800000"
  fontsize="13"
></label>

<checkbox
 name="My Check Box 1"
 x="12"
 y="176"
 w="126"
 h="19"
 label="purchase an e-book"
 labelPos="right"
 value="checked"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x800000"
></checkbox>

<checkbox
 name="My Check Box 2"
 x="12"
 y="196"
 w="172"
 h="19"
 label="monthly subscription service"
 labelPos="right"
 value="checked"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x800000"
></checkbox>

<checkbox
 name="My Check Box 3"
 x="12"
 y="216"
 w="92"
 h="19"
 label="either method"
 labelPos="right"
 value="checked"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x800000"
></checkbox>

<captcha
 name="My Captcha 1"
 x="100"
 y="376"
 w="133"
 h="100"
 text="Enter Key Here:"
 fnt="Arial"
 fntclr="0x800000"
 fntsize="11"
 bkbdrcolor="0x000000"
 bkfillclr="0xFFFFFF"
 bkdobdr="t"
 bkbdrsolid="t"
 bkdobk="t"
 bkfillalpha="100"
 message="Incorrect key!"
></captcha>

<label
 name="My Text 5"
 x="4"
 y="120"
 w="195"
 h="14"
 text="(Your privacy is our priority)"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x800000"
  fontsize="11"
></label>

</form>
