<html>
<head>
<title>Contact Form</title>
</head>
<body bgcolor="#FFFFFF">
<!-- change form action to your php script -->
<form action="contact.php" method="post">
<b>Name:<br><input type="text" name="name"><br><br>
<b>Company:<br><input type="text" name="company"><br><br>
<b>Title:<br><input type="text" name="title"><br><br>
<b>Address:<br><input type="text" name="address"><br><br>
<b>Address2:<br><input type="text" name="address2"><br><br>
<b>Phone:<br><input type="text" name="phone"><br><br>
<b>Email Address:<br><input type="text" name="emailaddress"><br><br>
<b>Comments:<textarea name="comments" cols="65" rows="20" wrap="VIRTUAL"></textarea><br>
<input type="submit" value="submit">
</form>
</body>
</html>