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<html>
<head>
<title>Outgoing Form</title>
<META HTTP-EQUIV="Refresh" CONTENT="4; URL=Message after Form.html">
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"></head>
<body background="Images/Background.jpg">
<FORM ACTION="MAILTO:Arfan_mahmood_786@hotmail.com" METHOD="POST">
<form action="--WEBBOT-SELF--" method="POST" enctype="text/plain">
<!--webbot bot="SaveResults" S-Builtin-Fields S-Form-Fields -->
<table width="71%" border="1" height="509">
<tr>
<td width="193" align="right">Surname:</td>
<td width="179"><input name="Surname" type="text" id="Surname" value="Surname">
</td>
</tr>
<tr>
<td width="193" align="right">First Name:</td>
<td><input name="First Name" type="text" id="First Name" value="First Name"></td>
</tr>
<tr>
<td width="193" align="right">Other Names:</td>
<td><input name="Other Names" type="text" id="Other Names" value="Other Names"></td>
</tr>
<tr>
<td width="193" align="right">Email Adress:</td>
<td><input name="Email Address" type="text" id="Email Address" value="Name@outgoing.com"></td>
</tr>
<tr>
<td width="193" align="right" height="28">Date Of Birth:</td>
<td height="28">
<input name="Date Of Birth Day" type="text" id="Date Of Birth Day" value="01-01-1980" size="20">
<b> (DD/MM/YYYY)</b></td>
</tr>
<tr>
<td width="193" height="26" align="right">Address </td>
<td><form name="form1" method="post" action="">
<input name="Address" type="text" id="Address" value="00 Outgoing Road">
</form>
<tr>
<td width="193" height="32" align="right">Post Code</td>
<td><form name="form2" method="post" action="">
<input name="Postcode" type="text" id="Postcode" value="OU1 1GO">
</form>
<tr>
<td align="right">How old are you:</td>
<td><select name="Age" id="Age">
<option>Please Choose</option>
<option>13-15</option>
<option>16-18</option>
<option>19-21</option>
</select>
</td>
</tr>
<tr>
<td align="right">Gender:</td>
<td><input type="radio" name="Gender" value="Male">
Male
<input type="radio" name="Gender" value="Female">
Female</td>
</tr>
<tr>
<td align="right">Type Of Holiday:</td>
<td><select name="Type of Trip" id="Type of Trip">
<option>Please Choose</option>
<option>Educational</option>
<option>Snow</option>
<option>Sun</option>
<option>Recreational</option>
</select>
</td>
</tr>
<tr>
<td align="right">Where About in Europe:</td>
<td><select name="Location of Trip" id="Location of Trip">
<option>Please Choose</option>
<option>Amsterdam</option>
<option>Dublin</option>
<option>Edinburgh</option>
<option>London</option>
<option>Paris</option>
</select>
</td>
</tr>
<tr>
<td width="193" align="right">How did you hear about us </td>
<td><form name="form3" method="post" action="">
<select name="How did u hear about us" id="How did u hear about us">
<option>Please Choose</option>
<option>Search Engine</option>
<option>Advertisment</option>
<option>Mate</option>
<option>Other</option>
</select>
</form>
<tr>
<td width="193" align="right">Comment</td>
<td><form name="form4" method="post" action="">
<textarea name="Comment" rows="5" id="Comment"></textarea>
</form>
<tr>
<td width="193" align="right"> </td>
<td>
<tr>
<td width="193" align="right"> </td>
<td>
<p align="center">
<INPUT TYPE="SUBMIT" VALUE="Mail It">
<input name="Rest" type="reset" id="Rest" value="Reset"></table>
<p align="center"> </p>
</body>
</html>
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