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public:contact_us [2019/02/22 18:55] – bmentink | public:contact_us [2022/07/21 12:50] (current) – bmentink |
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===== Contact us: ===== | ===== Contact us: ===== |
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| <fs large>You can email us at:</fs> |
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| {{:public:theellesmereecho2.png?400|email}} |
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<HTML> | |
<form name="htmlform" method="post" action="html_form_send.php"> | |
<table width="450px"> | |
</tr> | |
<tr> | |
<td valign="top"> | |
<label for="first_name">First Name*</label> | |
</td> | |
<td valign="top"> | |
<input type="text" name="first_name" maxlength="50" size="30"> | |
</td> | |
</tr> | |
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<tr> | |
<td valign="top""> | |
<label for="last_name">Last Name*</label> | |
</td> | |
<td valign="top"> | |
<input type="text" name="last_name" maxlength="50" size="30"> | |
</td> | |
</tr> | |
<tr> | |
<td valign="top"> | |
<label for="email">Email Address *</label> | |
</td> | |
<td valign="top"> | |
<input type="text" name="email" maxlength="80" size="30"> | |
</td> | |
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</tr> | |
<tr> | |
<td valign="top"> | |
<label for="telephone">Telephone Number</label> | |
</td> | |
<td valign="top"> | |
<input type="text" name="telephone" maxlength="30" size="30"> | |
</td> | |
</tr> | |
<tr> | |
<td valign="top"> | |
<label for="comments">Comments*</label> | |
</td> | |
<td valign="top"> | |
<textarea name="comments" maxlength="1000" cols="50" rows="10"></textarea> | |
</td> | |
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</tr> | |
<tr> | |
<td colspan="2" style="text-align:center"> | |
<input type="submit" value="Submit"> | |
</td> | |
</tr> | |
</table> | |
</form> | |
</HTML> | |
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<WRAP left> | <WRAP left> |
<fs 1.2em>You can also phone us on: Office: **03-7412206** Cell: **021-1093470** Fax: **03-7412207**</fs> | <fs 1.2em>You can also phone us on: Office: **03-7412206** Cell: **021-1093470** </fs>\\ |
| <fs 1.2em>Mail can be sent to: P.O Box 25 Leeston</fs> |
</WRAP> | </WRAP> |
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{{ :public:heron2.png?direct&50|}} | {{ :public:heron2.png?direct&50|}} |
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