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Text File  |  2003-04-18  |  3KB  |  80 lines
  1. <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
  2. <HTML>
  3.    <HEAD>
  4.       <TITLE>
  5.          DOCUMENT TITLE
  6.       </TITLE>
  7.       <META HTTP-EQUIV="DESCRIPTION" CONTENT="">
  8.       <META HTTP-EQUIV="KEYWORDS" CONTENT="">
  9.       <META HTTP-EQUIV="GENERATOR" CONTENT="MPS HTMLGATE XP - http://www.mpsoftware.dk">
  10.    </HEAD>
  11.    <BODY>
  12.       <H1>
  13.          <FONT FACE="Verdana" SIZE="2">Feedback</FONT>
  14.       </H1>
  15.       <HR WIDTH="90%" SIZE="1">
  16.       <P>
  17.          <FONT FACE="Verdana" SIZE="2">Tell us what you think about our web site, our products, our organization, or anything else that comes to mind. We welcome all of your comments and suggestions.</FONT>
  18.       </P>
  19.       <FORM ACTION="your_email@company.com" METHOD="post">
  20.          <P>
  21.             <FONT FACE="Verdana" SIZE="2">What kind of comment would you like to send?</FONT>
  22.          </P>
  23.          <DL>
  24.             <DD>
  25.                <FONT FACE="Verdana" SIZE="2"><INPUT TYPE="radio" NAME="MessageType" VALUE="Complaint">Complaint <INPUT TYPE="radio" NAME="MessageType" VALUE="Problem">Problem <INPUT TYPE="radio" CHECKED NAME="MessageType" VALUE="Suggestion">Suggestion <INPUT TYPE="radio" NAME="MessageType" VALUE="Praise </dl> <p><strong>What about us do you want to comment on?</strong></p> <dl> <dd><select name=" SIZE="1"> <SELECT SIZE="1">
  26.                   <OPTION SELECTED>
  27.                      Web Site
  28.                   </OPTION>
  29.                   <OPTION>
  30.                      Company
  31.                   </OPTION>
  32.                   <OPTION>
  33.                      Products
  34.                   </OPTION>
  35.                   <OPTION>
  36.                      Store
  37.                   </OPTION>
  38.                   <OPTION>
  39.                      Employee
  40.                   </OPTION>
  41.                   <OPTION>
  42.                      (Other)
  43.                   </OPTION>
  44.                </SELECT> Other: <INPUT TYPE="text" SIZE="26" MAXLENGTH="256" NAME="SubjectOther"></FONT>
  45.             </DD>
  46.          </DL>
  47.          <P>
  48.             <FONT FACE="Verdana" SIZE="2">Enter your comments in the space provided below:</FONT>
  49.          </P>
  50.          <DL>
  51.             <DD>
  52.                <FONT FACE="Verdana" SIZE="2">
  53.                <TEXTAREA NAME="Comments" ROWS="5" COLS="42">
  54. </TEXTAREA></FONT>
  55.             </DD>
  56.          </DL>
  57.          <P>
  58.             <FONT FACE="Verdana" SIZE="2">Tell us how to get in touch with you:</FONT>
  59.          </P>
  60.          <DL>
  61.             <DD>
  62.                <PRE>
  63. <FONT FACE="Verdana" SIZE="2">Name     <INPUT TYPE="text" SIZE="35" MAXLENGTH="256" NAME="UserName">
  64. E-mail   <INPUT TYPE="text" SIZE="35" MAXLENGTH="256" NAME="UserEmail">
  65. Tel      <INPUT TYPE="text" SIZE="35" MAXLENGTH="256" NAME="UserTel">
  66. FAX      <INPUT TYPE="text" SIZE="35" MAXLENGTH="256" NAME="UserFAX"></FONT>
  67.                </PRE>
  68.             </DD>
  69.          </DL>
  70.          <DL>
  71.             <DD>
  72.                <FONT FACE="Verdana" SIZE="2"><INPUT TYPE="checkbox" NAME="ContactRequested" VALUE="ContactRequested"> Please contact me as soon as possible regarding this matter.</FONT>
  73.             </DD>
  74.          </DL>
  75.          <P>
  76.             <FONT FACE="Verdana" SIZE="2"><INPUT TYPE="submit" VALUE="Submit Comments"> <INPUT TYPE="reset" VALUE="Clear Form"></FONT>
  77.          </P>
  78.       </FORM>
  79.    </BODY>
  80. </HTML>