Request

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=82 BGCOLOR="#006699" TEXT="#080000"> <div> <FONT SIZE="5" COLOR="#FFFFFF" FACE="Arial" ><B>Loco Logo</B></FONT><B>     |     </B><A HREF="index.htm" TARGET="_top" TITLE="Loco Logo"><U><B>home</B></U></A></div> <div> <A HREF="index.htm" TARGET="_top" TITLE="Loco Logo"><U>Loco Logo</U></A>   |   <A HREF="id2.htm" TARGET="_top" TITLE="About Me"><U>About Me</U></A>   |   <B>Request</B>   |   <A HREF="id5.htm" TARGET="_top" TITLE="Make a donation"><U>Make a donation</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000"> <div> <IMG SRC="01f7d280.gif" border=0 width="125" height="40" ALT="CorelDRAW 8.0 Graphic" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">  |     <A HREF="index.htm" TARGET="_top" TITLE="Loco Logo"><U>home</U></A></div> <bR> <bR> <bR> <div> <A HREF="index.htm" TARGET="_top" TITLE="Loco Logo"><U>Loco Logo</U></A>   |   <A HREF="id2.htm" TARGET="_top" TITLE="About Me"><U>About Me</U></A>   |   <B>Request</B>   |   <A HREF="id5.htm" TARGET="_top" TITLE="Make a donation"><U>Make a donation</U></A></div> </td> <td valign="top" height=398 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>Request</I></div> <div>  <form action="http://formmail.trellix.com/servlets/TlxMailer" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="Name,Email,Company,City,State,Zip,Phone,Comments"><input type="hidden" name="tlx_FormIndex" value="1"><input type="hidden" name="tlx_OKMessage" value="Thankyou for your request. I will get back to you in a couple of days with the first draft."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="A comment form was submitted"><input type="hidden" name="tlx_EmailTo" value="MrTickle35@aol.com"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">Name:<br> <input type="text" name="Name" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Company:<br> <input type="text" name="Company" size="30" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Zip:<br> <input type="text" name="Zip" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td align="left">Please fill out your request/Ideas:<br> <textarea name="Comments" rows="5" cols="30"></textarea></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> </td> </tr></table></body>