File: /home/frenchlanguagelessons.co.uk/public_html/includes/contact_form2.php
<link href="../frenchlessons_contact.css" rel="stylesheet" type="text/css" />
<blockquote>
<form action="contactus.php" method="post">
<table cellspacing="5" cellpadding="0" width="475" border="0">
<tbody>
<tr>
<td width="131"><font color="#FF0000">*</font> Name: </td>
<td width="225">
<input value="<?php if(isset($name)) { echo $name;} ?>" name="name" class="formField " tabindex="1" size="26" maxlength="80" /></td>
<td width="99" rowspan="6" > </td>
</tr>
<tr>
<td ><font color="#FF0000">*</font> Telephone:</td>
<td ><input value="<?php if(isset($telephone)) { echo $telephone;} ?>" name="telephone" class="formField" tabindex="2" size="26" maxlength="70" /></td>
</tr>
<tr>
<td width="131"><font color="#FF0000">* </font>Email: </font></td>
<td width="225">
<input value="<?php if(isset($email)) { echo $email;} ?>" name="email" class="formField " tabindex="3" size="26" maxlength="80" /></td>
</tr>
<tr>
<td width="131"><font color="#FF0000">*</font> Postcode:</font></td>
<td width="225">
<input value="<?php if(isset($postcode)) { echo $postcode;} ?>" name="postcode" class="formField " tabindex="5" size="26" maxlength="80" /></td>
</tr>
<tr>
<td ><font color="#FF0000">*</font> French Level</td>
<td ><label>
<select name="language" class="smalltext" id="language">
<option value="Unknown" selected="selected">French Level</option>
<option>Beginner</option>
<option>Post Beginner</option>
<option>GCSE</option>
<option>Intermediate</option>
<option>Advanced</option>
<option>Other</option>
</select>
</label></td>
</tr>
<tr>
<td ><font color="#FF0000">*</font> Who is paying for the lessons</td>
<td ><label>
<select name="learning" class="smalltext" id="learning">
<option value="Unkown!">Reason for learning French</option>
<option>Holiday</option>
<option>Pleasure</option>
<option>Business</option>
<option>Relocation</option>
<option>School</option>
<option>Other</option>
</select>
</label></td>
</tr>
<tr>
<td colspan="3"><p> </p>
<p><strong>Please use this box to tell us more about your French enquiry.</font></strong><br />
<br />
<textarea name="enquiry" cols="50" rows="6" wrap="off" class="formField" tabindex="8"></textarea>
</p></td>
</tr>
<tr>
<td colspan="3"><p><br />
<input class="button" tabindex="9" type="submit" value="submit" name="submit_form" />
</p>
<p> </p> </td>
</tr>
<tr>
<td height="89" colspan="3">Conversation Piece Ltd | The Warehouse Office Suites <br />
12 Ravensbury Terrace | London SW18 4RL | Tel:020 8337 1959 |<span class="copyright"><br />
</span></td>
</tr>
</tbody>
</table>
</form>
</blockquote>