<?xml version="1.0" encoding="UTF-8"?>

<form url="contact-2.php"
 window="_self"
 method="POST"
 fontname="MS Sans Serif"
 width="499"
 height="499"
 bkcolor="0xFFFFFF"
 transparent="f"
 fontcolor="0x000000"
 outlinecolor="0xFFFFFF"
 themecolor="0x000000"
 fontcolor2="#000000"
 bkcolor2="#FFFFFF"
 includeresults="false"
 emailuser="false"
 bcc=""
 cc=""
 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="thankyoupage"
 value="http://www.confluence-is.net/thank-you.htm"
></hidden>

<hidden
 name="subject"
 value="Confluence Work Inquiry"
></hidden>

<textinput
 name="firstname"
 x="97"
 y="16"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="lastname"
 x="341"
 y="16"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="Email"
 x="97"
 y="46"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
 emailbox="true"
  restrict="email"
>
</textinput>

<textinput
 name="organization"
 x="341"
 y="46"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="address"
 x="97"
 y="76"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="city"
 x="341"
 y="76"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="state"
 x="97"
 y="106"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="zip"
 x="341"
 y="106"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="dayphone"
 x="97"
 y="165"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="fax"
 x="341"
 y="136"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textarea
 name="comments"
 x="97"
 y="294"
 w="380"
 h="80"
 initvalue=""
 wordwrap="true"
 bkcolor="0xFFFFFF"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></textarea>

<submitbutton
 name="Submit Button"
 x="268"
 y="461"
 w="167"
 h="22"
 label="Submit to Confluence"
 fontname="Arial"
 fontcolor="0x000000"
  fontsize="12"
></submitbutton>

<textinput
 name="country"
 x="96"
 y="136"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="eve-phone"
 x="340"
 y="166"
 w="137"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="URL"
 x="169"
 y="196"
 w="308"
 h="22"
 initvalue="http://www"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<checkbox
 name="web-design"
 x="144"
 y="224"
 w="84"
 h="19"
 label="Web Design"
 labelPos="right"
 value="checked"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></checkbox>

<checkbox
 name="shopping-cart"
 x="242"
 y="224"
 w="95"
 h="19"
 label="Shopping Cart"
 labelPos="right"
 value="checked"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></checkbox>

<checkbox
 name="hosting"
 x="352"
 y="224"
 w="111"
 h="19"
 label="Web Site Hosting"
 labelPos="right"
 value="checked"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></checkbox>

<checkbox
 name="SEO"
 x="143"
 y="249"
 w="204"
 h="19"
 label="SEO (Search Engine Optimization)"
 labelPos="right"
 value="checked"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></checkbox>

<checkbox
 name="marketing"
 x="355"
 y="250"
 w="121"
 h="19"
 label="Web Site Marketing"
 labelPos="right"
 value="checked"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></checkbox>

<checkbox
 name="analysis"
 x="144"
 y="272"
 w="142"
 h="19"
 label="Free Web Site Analysis"
 labelPos="right"
 value="checked"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></checkbox>

<label
 name="My Text 1"
 x="21"
 y="19"
 w="72"
 h="16"
 text="First Name"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 2"
 x="263"
 y="17"
 w="71"
 h="16"
 text="Last Name"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 3"
 x="51"
 y="49"
 w="40"
 h="16"
 text="Email"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 4"
 x="248"
 y="47"
 w="86"
 h="16"
 text="Organization"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 5"
 x="37"
 y="79"
 w="54"
 h="16"
 text="Address"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 6"
 x="305"
 y="78"
 w="28"
 h="16"
 text="City"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 7"
 x="54"
 y="108"
 w="37"
 h="16"
 text="State"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 8"
 x="309"
 y="107"
 w="23"
 h="16"
 text="Zip"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 10"
 x="17"
 y="168"
 w="73"
 h="16"
 text="Day Phone"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 11"
 x="304"
 y="137"
 w="28"
 h="16"
 text="Fax"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 12"
 x="17"
 y="294"
 w="71"
 h="16"
 text="Comments"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<captcha
 name="My Captcha 1"
 x="96"
 y="385"
 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 9"
 x="264"
 y="385"
 w="182"
 h="16"
 text="Please enter the key to the left"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 13"
 x="280"
 y="433"
 w="148"
 h="16"
 text="Click here when finished:"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 14"
 x="36"
 y="138"
 w="53"
 h="16"
 text="Country"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 15"
 x="257"
 y="168"
 w="76"
 h="16"
 text="Eve. Phone"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 16"
 x="17"
 y="198"
 w="150"
 h="16"
 text="Please enter your URL:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 17"
 x="16"
 y="224"
 w="119"
 h="16"
 text="I am interested in:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

</form>