Top
Home
The Code for the Form

<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<HTML>
<HEAD>
<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=iso-8859-1">
<TITLE></TITLE>
<script>
function MooseMail() {
var x = document.forms["moose"]["Email"].value;
var atpos = x.indexOf("@");
var dotpos = x.lastIndexOf(".");
if (atpos< 1 || dotpos<atpos+2 || dotpos+2>=x.length) {
alert("Not a valid e-mail address");
return false;
}
}
</script>

<style type="text/css">

.moosebutt {
background-color: #808080;
padding-left:6px;
padding-right:6px;
padding-top:3px;
padding-bottom:3px;
color: #ffffff;
border:1px solid #000;
background-image: url(images/button_bg.jpg);
}

.moosebutt:hover {
background-color: #f00;
border:1px solid #000;
background-image: url(images/button_bg_over.jpg);
}

.moosetext {
background-color : #eee;
border: 1px solid #666;
width: 230px;
}

.moosetextarea {
width:230px;
height:60px;
background-color : #eee;
border: 1px solid #666;
font-family:sans-serif; }

.mooseform{
font-family:sans-serif;
font-size:10pt;
text-align:right}

.mooseselect{
background-color : #eee;
border: 1px solid #666;
  line-height: 1;
  border-radius: 10;
width: 230px;
  }

</style>
</HEAD>
<BODY>
<form name="moose" action="thankyou.php" onsubmit="return MooseMail();" method="post">
<table border="0" cellpadding="0" cellspacing="2" width="300">

START PASTING HERE

<tr>
<td></td>
<td><input class="moosebutt" type="submit" Value="Submit Message" name="submit"></td>
</tr>
</table>
</form>
</BODY>
</HTML>



Field Name:
Field Label:
Field Type
Choice 01:
Choice 02:
Choice 03:
Choice 04:
Choice 05:
Choice 06:
Choice 07:
Choice 08:
Choice 09:
Choice 10:
Choice 11:
Choice 12:
Choice 13:
Choice 14:
Choice 15: