<!-- start the form section --> You will NOT use this part of CSB's code!
<form action="hXXp://csbmail.globalscape.com/cgi-bin/csbmail/csbmail.pl" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="FirstName,LastName,Email,Company,Address1,Address2,City,State,Zip,Phone,MailingList">
<input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thank you for your subscription."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="A subscription form from website"><input type="hidden" name="tlx_EmailTo" value="111@111.org">
<!-- form field section -->
<table cellpadding="0" cellspacing="1" border="0" align="center">
<tr>
<td align="left">First Name:<br>
<input type="text" name="FirstName" size="30" maxlength="100"></td>
</tr>
<tr>
<td align="left">Last Name:<br>
<input type="text" name="LastName" 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">Address Line 1:<br>
<input type="text" name="Address1" size="30" maxlength="100"></td>
</tr>
<tr>
<td align="left">Address Line 2:<br>
<input type="text" name="Address2" 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>
<input type="checkbox" name="MailingList" value="yes"> By submitting this form, I acknowledge that I have sent my subscription via credit card. Once receipt of funds has been confirmed, I understand I will receive the next published issue of the magazine.</td>
</tr>
</table>
<!-- the end of the form -->
<tr>
<td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td>
</tr>
</form>
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