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<?xml version="1.0" ?>
<!DOCTYPE html PUBLIC “-//W3C//DTD XHTML 1.0 Transitional//EN"
“http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" lang="en" xml:lang="en">
<head>
<title>Contact Us</title>
</head>
<body>
<h1>Contact Us</h1>
<p> Use the following form to send a message to Example Cafe </p>
<table>
<tr>
<td>Your email</td>
<td> <input type="text" name="txtFrom" id="emailFrom"
size="20" maxlength="250" /> </td>
</tr>
<tr>
<td> Message </td>
<td> <textarea name="txtBody" id="emailBody" cols="50"
rows="10"> </textarea> </td>
</tr>
<tr>
<td> How did you hear of us? </td>
<td>
<select name="selReferrer">
<option value="google"> Google </option>
<option value="ad">Local newspaper ad</option>
<option value="friend"> Friend </option>
<option value="other"> Other </option>
</select>
</td>
</tr>
<tr>
<td> Newsletter </td>
<td> <input type="checkbox" name="chkBody" id="newsletterSignup"
checked="checked" />
Ensure this box is checked if you would like to
receive email updates </td>
</tr>
</table>
<input type="submit" value="Send message" />
</body>
</html>