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  1.  
  2. <FORM Name=”WEB2LEAD” method=”POST” OnSubmit=”return CreateAction()”>
  3. <SCRIPT>function CreateAction()
  4. {if (document.WEB2LEAD.SELECTWorkFlow == null)document.WEB2LEAD.action = “https://midwestconstructionproductscorp.applianzsystem.com/CRMMCP/eware.dll/SubmitLead?RuleID=”;else document.WEB2LEAD.action = “https://midwestconstructionproductscorp.applianzsystem.com/CRMMCP/eware.dll/SubmitLead?RuleID=” + document.WEB2LEAD.SELECTWorkFlow.options[document.WEB2LEAD.SELECTWorkFlow.selectedIndex].value;return true;
  5. }
  6. </SCRIPT>
  7.  
  8. <TABLE WIDTH=580 CLASS=CONTENT>
  9. <TR>
  10. <TD width=”580″ height=”50″ VALIGN=TOP ><h3>Contact Us</h3></TD>
  11. </TR>
  12.  
  13. <TR>
  14. <TD width=”580″ height=”50″ VALIGN=TOP ><SPAN ID=_Captlead_personfirstname class=VIEWBOXCAPTION>First Name:</SPAN>
  15. <BR><SPAN ID=_Datalead_personfirstname class=VIEWBOX ><input name=”lead_personfirstname” type=”text” CLASS=EDIT ID=”lead_personfirstname” value=”” size=”60″ maxlength=30><input type=hidden name=_HIDDENlead_personfirstname value=””><span CLASS=VIEWBOXNOBG><font color=”red” >*</font></span></SPAN>
  16. </TD>
  17.  
  18. </TR>
  19.  
  20. <TR>
  21. <TD width=”580″ height=”50″ VALIGN=TOP ><SPAN ID=_Captlead_personlastname class=VIEWBOXCAPTION>Last Name:</SPAN>
  22. <BR><SPAN ID=_Datalead_personlastname class=VIEWBOX ><input name=”lead_personlastname” type=”text” CLASS=EDIT ID=”lead_personlastname” value=”” size=”60″ maxlength=30><input type=hidden name=_HIDDENlead_personlastname value=””><span CLASS=VIEWBOXNOBG><font color=”red” >*</font></span></SPAN>
  23. </TD>
  24.  
  25. </TR>
  26.  
  27. <TR>
  28. <TD width=”580″ height=”50″ VALIGN=TOP ><SPAN ID=_Captlead_companyname class=VIEWBOXCAPTION>Company Name or Residential:</SPAN>
  29. <BR><SPAN ID=_Datalead_companyname class=VIEWBOX ><input name=”lead_companyname” type=”text” CLASS=EDIT ID=”lead_companyname” value=”” size=”60″ maxlength=60><input type=hidden name=_HIDDENlead_companyname value=””><span CLASS=VIEWBOXNOBG><font color=”red” >*</font></span></SPAN>
  30. </TD>
  31.  
  32. </TR>
  33.  
  34. <TR>
  35. <TD width=”580″ height=”50″ VALIGN=TOP style=”width: 270px” ><SPAN ID=_Captlead_companystate class=VIEWBOXCAPTION>State:</SPAN>
  36. <BR><SPAN ID=_Datalead_companystate class=VIEWBOX >
  37. <SELECT class=EDIT size=0 name=”lead_companystate”>
  38. <OPTION Value=”AL”>Alabama
  39. </OPTION>
  40.  
  41. <OPTION Value=”AK”>Alaska
  42. </OPTION>
  43.  
  44. <OPTION Value=”AZ”>Arizona
  45. </OPTION>
  46.  
  47. <OPTION Value=”AR”>Arkansas
  48. </OPTION>
  49.  
  50. <OPTION Value=”CA”>California
  51. </OPTION>
  52.  
  53. <OPTION Value=”CO”>Colorado
  54. </OPTION>
  55.  
  56. <OPTION Value=”CT”>Connecticut
  57. </OPTION>
  58.  
  59. <OPTION Value=”DE”>Delaware
  60. </OPTION>
  61.  
  62. <OPTION Value=”DC”>District of Columbia
  63. </OPTION>
  64.  
  65. <OPTION Value=”FL”>Florida
  66. </OPTION>
  67.  
  68. <OPTION Value=”GA”>Georgia
  69. </OPTION>
  70.  
  71. <OPTION Value=”HI”>Hawaii
  72. </OPTION>
  73.  
  74. <OPTION Value=”ID”>Idaho
  75. </OPTION>
  76.  
  77. <OPTION Value=”IL”>Illinois
  78. </OPTION>
  79.  
  80. <OPTION Value=”IN”>Indiana
  81. </OPTION>
  82.  
  83. <OPTION Value=”IA”>Iowa
  84. </OPTION>
  85.  
  86. <OPTION Value=”KS”>Kansas
  87. </OPTION>
  88.  
  89. <OPTION Value=”KY”>Kentucky
  90. </OPTION>
  91.  
  92. <OPTION Value=”LA”>Louisiana
  93. </OPTION>
  94.  
  95. <OPTION Value=”ME”>Maine
  96. </OPTION>
  97.  
  98. <OPTION Value=”MD”>Maryland
  99. </OPTION>
  100.  
  101. <OPTION Value=”MA”>Massachusetts
  102. </OPTION>
  103.  
  104. <OPTION Value=”MI”>Michigan
  105. </OPTION>
  106.  
  107. <OPTION Value=”MN”>Minnesota
  108. </OPTION>
  109.  
  110. <OPTION Value=”MS”>Mississippi
  111. </OPTION>
  112.  
  113. <OPTION Value=”MO”>Missouri
  114. </OPTION>
  115.  
  116. <OPTION Value=”MT”>Montana
  117. </OPTION>
  118.  
  119. <OPTION Value=”NE”>Nebraska
  120. </OPTION>
  121.  
  122. <OPTION Value=”NV”>Nevada
  123. </OPTION>
  124.  
  125. &lt;OPTION Value=&#8221;NH&#8221;&gt;New Hamps<a href='http://www.kriesi.at/contact/customization' target='_blank' rel="nofollow">hire</a>
  126. &lt;/OPTION&gt;
  127.  
  128. &lt;OPTION Value=&#8221;NJ&#8221;&gt;New Jersey
  129. &lt;/OPTION&gt;
  130.  
  131. &lt;OPTION Value=&#8221;NM&#8221;&gt;New Mexico
  132. &lt;/OPTION&gt;
  133.  
  134. &lt;OPTION Value=&#8221;NY&#8221;&gt;New York
  135. &lt;/OPTION&gt;
  136.  
  137. &lt;OPTION Value=&#8221;NC&#8221;&gt;North Carolina
  138. &lt;/OPTION&gt;
  139.  
  140. &lt;OPTION Value=&#8221;ND&#8221;&gt;North Dakota
  141. &lt;/OPTION&gt;
  142.  
  143. &lt;OPTION Value=&#8221;OH&#8221;&gt;Ohio
  144. &lt;/OPTION&gt;
  145.  
  146. &lt;OPTION Value=&#8221;OK&#8221;&gt;Oklahoma
  147. &lt;/OPTION&gt;
  148.  
  149. &lt;OPTION Value=&#8221;OR&#8221;&gt;Oregon
  150. &lt;/OPTION&gt;
  151.  
  152. &lt;OPTION Value=&#8221;PA&#8221;&gt;Pennsylvania
  153. &lt;/OPTION&gt;
  154.  
  155. &lt;OPTION Value=&#8221;RI&#8221;&gt;Rhode Island
  156. &lt;/OPTION&gt;
  157.  
  158. &lt;OPTION Value=&#8221;SC&#8221;&gt;South Carolina
  159. &lt;/OPTION&gt;
  160.  
  161. &lt;OPTION Value=&#8221;SD&#8221;&gt;South Dakota
  162. &lt;/OPTION&gt;
  163.  
  164. &lt;OPTION Value=&#8221;TN&#8221;&gt;Tennessee
  165. &lt;/OPTION&gt;
  166.  
  167. &lt;OPTION Value=&#8221;TX&#8221;&gt;Texas
  168. &lt;/OPTION&gt;
  169.  
  170. &lt;OPTION Value=&#8221;UT&#8221;&gt;Utah
  171. &lt;/OPTION&gt;
  172.  
  173. &lt;OPTION Value=&#8221;VT&#8221;&gt;Vermont
  174. &lt;/OPTION&gt;
  175.  
  176. &lt;OPTION Value=&#8221;VA&#8221;&gt;Virginia
  177. &lt;/OPTION&gt;
  178.  
  179. &lt;OPTION Value=&#8221;WA&#8221;&gt;Washington
  180. &lt;/OPTION&gt;
  181.  
  182. &lt;OPTION Value=&#8221;WV&#8221;&gt;West Virginia
  183. &lt;/OPTION&gt;
  184.  
  185. &lt;OPTION Value=&#8221;WI&#8221;&gt;Wisconsin
  186. &lt;/OPTION&gt;
  187.  
  188. &lt;OPTION Value=&#8221;WY&#8221;&gt;Wyoming
  189. &lt;/OPTION&gt;
  190.  
  191. &lt;OPTION Value=&#8221;AS&#8221;&gt;American Samoa
  192. &lt;/OPTION&gt;
  193.  
  194. &lt;OPTION Value=&#8221;GU&#8221;&gt;Guam
  195. &lt;/OPTION&gt;
  196.  
  197. &lt;OPTION Value=&#8221;MP&#8221;&gt;Northern Mariana Islands
  198. &lt;/OPTION&gt;
  199.  
  200. &lt;OPTION Value=&#8221;PR&#8221;&gt;Puerto Rico
  201. &lt;/OPTION&gt;
  202.  
  203. &lt;OPTION Value=&#8221;VI&#8221;&gt;Virgin Islands
  204. &lt;/OPTION&gt;
  205.  
  206. &lt;OPTION Value=&#8221;UM&#8221;&gt;US Minor Outlying Islands
  207. &lt;/OPTION&gt;
  208.  
  209. &lt;OPTION Value=&#8221;OC&#8221;&gt;Other Country
  210. &lt;/OPTION&gt;
  211.  
  212. &lt;OPTION VALUE=&#8221;&#8221; SELECTED&gt;&#8211;None&#8211;
  213. &lt;/OPTION&gt;
  214.  
  215. &lt;/SELECT&gt;
  216. &lt;input type=hidden name=_HIDDENlead_companystate value=&#8221;&#8221;&gt;&lt;span CLASS=VIEWBOXNOBG&gt;&lt;font color=&#8221;red&#8221; &gt;*&lt;/font&gt;&lt;/span&gt;&lt;/SPAN&gt;
  217. &lt;/TD&gt;
  218. &lt;/TR&gt;
  219.  
  220. &lt;TR&gt;
  221. &lt;TD width=&#8221;580&#8243; height=&#8221;50&#8243; VALIGN=TOP &gt;&lt;SPAN ID=_Captlead_companypostcode class=VIEWBOXCAPTION&gt;Zip Code:&lt;/SPAN&gt;
  222. &lt;BR&gt;&lt;SPAN ID=_Datalead_companypostcode class=VIEWBOX &gt;&lt;input name=&#8221;lead_companypostcode&#8221; type=&#8221;text&#8221; CLASS=EDIT ID=&#8221;lead_companypostcode&#8221; value=&#8221;&#8221; size=&#8221;30&#8243; maxlength=10&gt;&lt;input type=hidden name=_HIDDENlead_companypostcode value=&#8221;&#8221;&gt;&lt;span CLASS=VIEWBOXNOBG&gt;&lt;font color=&#8221;red&#8221; &gt;*&lt;/font&gt;&lt;/span&gt;&lt;/SPAN&gt;
  223. &lt;/TD&gt;
  224.  
  225. &lt;/TR&gt;
  226.  
  227. &lt;TR&gt;
  228. &lt;TD width=&#8221;580&#8243; height=&#8221;50&#8243; VALIGN=TOP &gt;&lt;SPAN ID=_Captlead_companycountry class=VIEWBOXCAPTION&gt;Country:&lt;/SPAN&gt;
  229. &lt;BR&gt;&lt;SPAN ID=_Datalead_companycountry class=VIEWBOX &gt;
  230. &lt;SELECT class=EDIT size=0 name=&#8221;lead_companycountry&#8221;&gt;
  231. &lt;OPTION Value=&#8221;AF&#8221;&gt;Afghanistan, Islamic State
  232. &lt;/OPTION&gt;
  233.  
  234. &lt;OPTION Value=&#8221;AL&#8221;&gt;Albania
  235. &lt;/OPTION&gt;
  236.  
  237. &lt;OPTION Value=&#8221;DZ&#8221;&gt;Algeria
  238. &lt;/OPTION&gt;
  239.  
  240. &lt;OPTION Value=&#8221;AS&#8221;&gt;American Samoa
  241. &lt;/OPTION&gt;
  242.  
  243. &lt;OPTION Value=&#8221;AD&#8221;&gt;Andorra, Principality of
  244. &lt;/OPTION&gt;
  245.  
  246. &lt;OPTION Value=&#8221;AO&#8221;&gt;Angola
  247. &lt;/OPTION&gt;
  248.  
  249. &lt;OPTION Value=&#8221;AI&#8221;&gt;Anguilla
  250. &lt;/OPTION&gt;
  251.  
  252. &lt;OPTION Value=&#8221;AQ&#8221;&gt;Antarctica
  253. &lt;/OPTION&gt;
  254.  
  255. &lt;OPTION Value=&#8221;AG&#8221;&gt;Antigua and Barbuda
  256. &lt;/OPTION&gt;
  257.  
  258. &lt;OPTION Value=&#8221;AR&#8221;&gt;Argentina
  259. &lt;/OPTION&gt;
  260.  
  261. &lt;OPTION Value=&#8221;AM&#8221;&gt;Armenia
  262. &lt;/OPTION&gt;
  263.  
  264. &lt;OPTION Value=&#8221;AW&#8221;&gt;Aruba
  265. &lt;/OPTION&gt;
  266.  
  267. &lt;OPTION Value=&#8221;AU&#8221;&gt;Australia
  268. &lt;/OPTION&gt;
  269.  
  270. &lt;OPTION Value=&#8221;AT&#8221;&gt;Austria
  271. &lt;/OPTION&gt;
  272.  
  273. &lt;OPTION Value=&#8221;AZ&#8221;&gt;Azerbaidjan
  274. &lt;/OPTION&gt;
  275.  
  276. &lt;OPTION Value=&#8221;BS&#8221;&gt;Bahamas
  277. &lt;/OPTION&gt;
  278.  
  279. &lt;OPTION Value=&#8221;BH&#8221;&gt;Bahrain
  280. &lt;/OPTION&gt;
  281.  
  282. &lt;OPTION Value=&#8221;BD&#8221;&gt;Bangladesh
  283. &lt;/OPTION&gt;
  284.  
  285. &lt;OPTION Value=&#8221;BB&#8221;&gt;Barbados
  286. &lt;/OPTION&gt;
  287.  
  288. &lt;OPTION Value=&#8221;BY&#8221;&gt;Belarus
  289. &lt;/OPTION&gt;
  290.  
  291. &lt;OPTION Value=&#8221;BE&#8221;&gt;Belgium
  292. &lt;/OPTION&gt;
  293.  
  294. &lt;OPTION Value=&#8221;BZ&#8221;&gt;Belize
  295. &lt;/OPTION&gt;
  296.  
  297. &lt;OPTION Value=&#8221;BJ&#8221;&gt;Benin
  298. &lt;/OPTION&gt;
  299.  
  300. &lt;OPTION Value=&#8221;BM&#8221;&gt;Bermuda
  301. &lt;/OPTION&gt;
  302.  
  303. &lt;OPTION Value=&#8221;BT&#8221;&gt;Bhutan
  304. &lt;/OPTION&gt;
  305.  
  306. &lt;OPTION Value=&#8221;BO&#8221;&gt;Bolivia
  307. &lt;/OPTION&gt;
  308.  
  309. &lt;OPTION Value=&#8221;BA&#8221;&gt;Bosnia-Herzegovina
  310. &lt;/OPTION&gt;
  311.  
  312. &lt;OPTION Value=&#8221;BW&#8221;&gt;Botswana
  313. &lt;/OPTION&gt;
  314.  
  315. &lt;OPTION Value=&#8221;BV&#8221;&gt;Bouvet Island
  316. &lt;/OPTION&gt;
  317.  
  318. &lt;OPTION Value=&#8221;BR&#8221;&gt;Brazil
  319. &lt;/OPTION&gt;
  320.  
  321. &lt;OPTION Value=&#8221;IO&#8221;&gt;British Indian Ocean Terr.
  322. &lt;/OPTION&gt;
  323.  
  324. &lt;OPTION Value=&#8221;BN&#8221;&gt;Brunei Darussalam
  325. &lt;/OPTION&gt;
  326.  
  327. &lt;OPTION Value=&#8221;BG&#8221;&gt;Bulgaria
  328. &lt;/OPTION&gt;
  329.  
  330. &lt;OPTION Value=&#8221;BF&#8221;&gt;Burkina Faso
  331. &lt;/OPTION&gt;
  332.  
  333. &lt;OPTION Value=&#8221;BI&#8221;&gt;Burundi
  334. &lt;/OPTION&gt;
  335.  
  336. &lt;OPTION Value=&#8221;KH&#8221;&gt;Cambodia, Kingdom of
  337. &lt;/OPTION&gt;
  338.  
  339. &lt;OPTION Value=&#8221;CM&#8221;&gt;Cameroon
  340. &lt;/OPTION&gt;
  341.  
  342. &lt;OPTION Value=&#8221;CA&#8221;&gt;Canada
  343. &lt;/OPTION&gt;
  344.  
  345. &lt;OPTION Value=&#8221;CV&#8221;&gt;Cape Verde
  346. &lt;/OPTION&gt;
  347.  
  348. &lt;OPTION Value=&#8221;KY&#8221;&gt;Cayman Islands
  349. &lt;/OPTION&gt;
  350.  
  351. &lt;OPTION Value=&#8221;CF&#8221;&gt;Central African Republic
  352. &lt;/OPTION&gt;
  353.  
  354. &lt;OPTION Value=&#8221;TD&#8221;&gt;Chad
  355. &lt;/OPTION&gt;
  356.  
  357. &lt;OPTION Value=&#8221;CL&#8221;&gt;Chile
  358. &lt;/OPTION&gt;
  359.  
  360. &lt;OPTION Value=&#8221;CN&#8221;&gt;China
  361. &lt;/OPTION&gt;
  362.  
  363. &lt;OPTION Value=&#8221;CX&#8221;&gt;Christmas Island
  364. &lt;/OPTION&gt;
  365.  
  366. &lt;OPTION Value=&#8221;CC&#8221;&gt;Cocos (Keeling) Islands
  367. &lt;/OPTION&gt;
  368.  
  369. &lt;OPTION Value=&#8221;CO&#8221;&gt;Colombia
  370. &lt;/OPTION&gt;
  371.  
  372. &lt;OPTION Value=&#8221;KM&#8221;&gt;Comoros
  373. &lt;/OPTION&gt;
  374.  
  375. &lt;OPTION Value=&#8221;CG&#8221;&gt;Congo
  376. &lt;/OPTION&gt;
  377.  
  378. &lt;OPTION Value=&#8221;CD&#8221;&gt;Congo, Democratic Republic
  379. &lt;/OPTION&gt;
  380.  
  381. &lt;OPTION Value=&#8221;CK&#8221;&gt;Cook Islands
  382. &lt;/OPTION&gt;
  383.  
  384. &lt;OPTION Value=&#8221;CR&#8221;&gt;Costa Rica
  385. &lt;/OPTION&gt;
  386.  
  387. &lt;OPTION Value=&#8221;HR&#8221;&gt;Croatia
  388. &lt;/OPTION&gt;
  389.  
  390. &lt;OPTION Value=&#8221;CU&#8221;&gt;Cuba
  391. &lt;/OPTION&gt;
  392.  
  393. &lt;OPTION Value=&#8221;CY&#8221;&gt;Cyprus
  394. &lt;/OPTION&gt;
  395.  
  396. &lt;OPTION Value=&#8221;CZ&#8221;&gt;Czech Republic
  397. &lt;/OPTION&gt;
  398.  
  399. &lt;OPTION Value=&#8221;DK&#8221;&gt;Denmark
  400. &lt;/OPTION&gt;
  401.  
  402. &lt;OPTION Value=&#8221;DJ&#8221;&gt;Djibouti
  403. &lt;/OPTION&gt;
  404.  
  405. &lt;OPTION Value=&#8221;DM&#8221;&gt;Dominica
  406. &lt;/OPTION&gt;
  407.  
  408. &lt;OPTION Value=&#8221;DO&#8221;&gt;Dominican Republic
  409. &lt;/OPTION&gt;
  410.  
  411. &lt;OPTION Value=&#8221;TP&#8221;&gt;East Timor
  412. &lt;/OPTION&gt;
  413.  
  414. &lt;OPTION Value=&#8221;EC&#8221;&gt;Ecuador
  415. &lt;/OPTION&gt;
  416.  
  417. &lt;OPTION Value=&#8221;EG&#8221;&gt;Egypt
  418. &lt;/OPTION&gt;
  419.  
  420. &lt;OPTION Value=&#8221;SV&#8221;&gt;El Salvador
  421. &lt;/OPTION&gt;
  422.  
  423. &lt;OPTION Value=&#8221;GQ&#8221;&gt;Equatorial Guinea
  424. &lt;/OPTION&gt;
  425.  
  426. &lt;OPTION Value=&#8221;ER&#8221;&gt;Eritrea
  427. &lt;/OPTION&gt;
  428.  
  429. &lt;OPTION Value=&#8221;EE&#8221;&gt;Estonia
  430. &lt;/OPTION&gt;
  431.  
  432. &lt;OPTION Value=&#8221;ET&#8221;&gt;Ethiopia
  433. &lt;/OPTION&gt;
  434.  
  435. &lt;OPTION Value=&#8221;FK&#8221;&gt;Falkland Islands
  436. &lt;/OPTION&gt;
  437.  
  438. &lt;OPTION Value=&#8221;FO&#8221;&gt;Faroe Islands
  439. &lt;/OPTION&gt;
  440.  
  441. &lt;OPTION Value=&#8221;FJ&#8221;&gt;Fiji
  442. &lt;/OPTION&gt;
  443.  
  444. &lt;OPTION Value=&#8221;FI&#8221;&gt;Finland
  445. &lt;/OPTION&gt;
  446.  
  447. &lt;OPTION Value=&#8221;CS&#8221;&gt;Former Czechoslovakia
  448. &lt;/OPTION&gt;
  449.  
  450. &lt;OPTION Value=&#8221;SU&#8221;&gt;Former USSR
  451. &lt;/OPTION&gt;
  452.  
  453. &lt;OPTION Value=&#8221;FR&#8221;&gt;France
  454. &lt;/OPTION&gt;
  455.  
  456. &lt;OPTION Value=&#8221;FX&#8221;&gt;France (European Territory)
  457. &lt;/OPTION&gt;
  458.  
  459. &lt;OPTION Value=&#8221;GF&#8221;&gt;French Guyana
  460. &lt;/OPTION&gt;
  461.  
  462. &lt;OPTION Value=&#8221;TF&#8221;&gt;French Southern Territories
  463. &lt;/OPTION&gt;
  464.  
  465. &lt;OPTION Value=&#8221;GA&#8221;&gt;Gabon
  466. &lt;/OPTION&gt;
  467.  
  468. &lt;OPTION Value=&#8221;GM&#8221;&gt;Gambia
  469. &lt;/OPTION&gt;
  470.  
  471. &lt;OPTION Value=&#8221;GE&#8221;&gt;Georgia
  472. &lt;/OPTION&gt;
  473.  
  474. &lt;OPTION Value=&#8221;DE&#8221;&gt;Germany
  475. &lt;/OPTION&gt;
  476.  
  477. &lt;OPTION Value=&#8221;GH&#8221;&gt;Ghana
  478. &lt;/OPTION&gt;
  479.  
  480. &lt;OPTION Value=&#8221;GI&#8221;&gt;Gibraltar
  481. &lt;/OPTION&gt;
  482.  
  483. &lt;OPTION Value=&#8221;GB&#8221;&gt;Great Britain
  484. &lt;/OPTION&gt;
  485.  
  486. &lt;OPTION Value=&#8221;GR&#8221;&gt;Greece
  487. &lt;/OPTION&gt;
  488.  
  489. &lt;OPTION Value=&#8221;GL&#8221;&gt;Greenland
  490. &lt;/OPTION&gt;
  491.  
  492. &lt;OPTION Value=&#8221;GD&#8221;&gt;Grenada
  493. &lt;/OPTION&gt;
  494.  
  495. &lt;OPTION Value=&#8221;GP&#8221;&gt;Guadeloupe (French)
  496. &lt;/OPTION&gt;
  497.  
  498. &lt;OPTION Value=&#8221;GU&#8221;&gt;Guam (USA)
  499. &lt;/OPTION&gt;
  500.  
  501. &lt;OPTION Value=&#8221;GT&#8221;&gt;Guatemala
  502. &lt;/OPTION&gt;
  503.  
  504. &lt;OPTION Value=&#8221;GN&#8221;&gt;Guinea
  505. &lt;/OPTION&gt;
  506.  
  507. &lt;OPTION Value=&#8221;GW&#8221;&gt;Guinea Bissau
  508. &lt;/OPTION&gt;
  509.  
  510. &lt;OPTION Value=&#8221;GY&#8221;&gt;Guyana
  511. &lt;/OPTION&gt;
  512.  
  513. &lt;OPTION Value=&#8221;HT&#8221;&gt;Haiti
  514. &lt;/OPTION&gt;
  515.  
  516. &lt;OPTION Value=&#8221;HM&#8221;&gt;Heard and McDonald Islands
  517. &lt;/OPTION&gt;
  518.  
  519. &lt;OPTION Value=&#8221;VA&#8221;&gt;Holy See (Vatican City)
  520. &lt;/OPTION&gt;
  521.  
  522. &lt;OPTION Value=&#8221;HN&#8221;&gt;Honduras
  523. &lt;/OPTION&gt;
  524.  
  525. &lt;OPTION Value=&#8221;HK&#8221;&gt;Hong Kong
  526. &lt;/OPTION&gt;
  527.  
  528. &lt;OPTION Value=&#8221;HU&#8221;&gt;Hungary
  529. &lt;/OPTION&gt;
  530.  
  531. &lt;OPTION Value=&#8221;IS&#8221;&gt;Iceland
  532. &lt;/OPTION&gt;
  533.  
  534. &lt;OPTION Value=&#8221;IN&#8221;&gt;India
  535. &lt;/OPTION&gt;
  536.  
  537. &lt;OPTION Value=&#8221;IR&#8221;&gt;Iran
  538. &lt;/OPTION&gt;
  539.  
  540. &lt;OPTION Value=&#8221;IQ&#8221;&gt;Iraq
  541. &lt;/OPTION&gt;
  542.  
  543. &lt;OPTION Value=&#8221;IE&#8221;&gt;Ireland
  544. &lt;/OPTION&gt;
  545.  
  546. &lt;OPTION Value=&#8221;IL&#8221;&gt;Israel
  547. &lt;/OPTION&gt;
  548.  
  549. &lt;OPTION Value=&#8221;IT&#8221;&gt;Italy
  550. &lt;/OPTION&gt;
  551.  
  552. &lt;OPTION Value=&#8221;CI&#8221;&gt;Ivory Coast (Cote D&#8217;Ivoire)
  553. &lt;/OPTION&gt;
  554.  
  555. &lt;OPTION Value=&#8221;JM&#8221;&gt;Jamaica
  556. &lt;/OPTION&gt;
  557.  
  558. &lt;OPTION Value=&#8221;JP&#8221;&gt;Japan
  559. &lt;/OPTION&gt;
  560.  
  561. &lt;OPTION Value=&#8221;JO&#8221;&gt;Jordan
  562. &lt;/OPTION&gt;
  563.  
  564. &lt;OPTION Value=&#8221;KZ&#8221;&gt;Kazakhstan
  565. &lt;/OPTION&gt;
  566.  
  567. &lt;OPTION Value=&#8221;KE&#8221;&gt;Kenya
  568. &lt;/OPTION&gt;
  569.  
  570. &lt;OPTION Value=&#8221;KI&#8221;&gt;Kiribati
  571. &lt;/OPTION&gt;
  572.  
  573. &lt;OPTION Value=&#8221;KW&#8221;&gt;Kuwait
  574. &lt;/OPTION&gt;
  575.  
  576. &lt;OPTION Value=&#8221;KG&#8221;&gt;Kyrgyz Republic (Kyrgyzstan)
  577. &lt;/OPTION&gt;
  578.  
  579. &lt;OPTION Value=&#8221;LA&#8221;&gt;Laos
  580. &lt;/OPTION&gt;
  581.  
  582. &lt;OPTION Value=&#8221;LV&#8221;&gt;Latvia
  583. &lt;/OPTION&gt;
  584.  
  585. &lt;OPTION Value=&#8221;LB&#8221;&gt;Lebanon
  586. &lt;/OPTION&gt;
  587.  
  588. &lt;OPTION Value=&#8221;LS&#8221;&gt;Lesotho
  589. &lt;/OPTION&gt;
  590.  
  591. &lt;OPTION Value=&#8221;LR&#8221;&gt;Liberia
  592. &lt;/OPTION&gt;
  593.  
  594. &lt;OPTION Value=&#8221;LY&#8221;&gt;Libya
  595. &lt;/OPTION&gt;
  596.  
  597. &lt;OPTION Value=&#8221;LI&#8221;&gt;Liechtenstein
  598. &lt;/OPTION&gt;
  599.  
  600. &lt;OPTION Value=&#8221;LT&#8221;&gt;Lithuania
  601. &lt;/OPTION&gt;
  602.  
  603. &lt;OPTION Value=&#8221;LU&#8221;&gt;Luxembourg
  604. &lt;/OPTION&gt;
  605.  
  606. &lt;OPTION Value=&#8221;MO&#8221;&gt;Macau
  607. &lt;/OPTION&gt;
  608.  
  609. &lt;OPTION Value=&#8221;MK&#8221;&gt;Macedonia
  610. &lt;/OPTION&gt;
  611.  
  612. &lt;OPTION Value=&#8221;MG&#8221;&gt;Madagascar
  613. &lt;/OPTION&gt;
  614.  
  615. &lt;OPTION Value=&#8221;MW&#8221;&gt;Malawi
  616. &lt;/OPTION&gt;
  617.  
  618. &lt;OPTION Value=&#8221;MY&#8221;&gt;Malaysia
  619. &lt;/OPTION&gt;
  620.  
  621. &lt;OPTION Value=&#8221;MV&#8221;&gt;Maldives
  622. &lt;/OPTION&gt;
  623.  
  624. &lt;OPTION Value=&#8221;ML&#8221;&gt;Mali
  625. &lt;/OPTION&gt;
  626.  
  627. &lt;OPTION Value=&#8221;MT&#8221;&gt;Malta
  628. &lt;/OPTION&gt;
  629.  
  630. &lt;OPTION Value=&#8221;MH&#8221;&gt;Marshall Islands
  631. &lt;/OPTION&gt;
  632.  
  633. &lt;OPTION Value=&#8221;MQ&#8221;&gt;Martinique (French)
  634. &lt;/OPTION&gt;
  635.  
  636. &lt;OPTION Value=&#8221;MR&#8221;&gt;Mauritania
  637. &lt;/OPTION&gt;
  638.  
  639. &lt;OPTION Value=&#8221;MU&#8221;&gt;Mauritius
  640. &lt;/OPTION&gt;
  641.  
  642. &lt;OPTION Value=&#8221;YT&#8221;&gt;Mayotte
  643. &lt;/OPTION&gt;
  644.  
  645. &lt;OPTION Value=&#8221;MX&#8221;&gt;Mexico
  646. &lt;/OPTION&gt;
  647.  
  648. &lt;OPTION Value=&#8221;FM&#8221;&gt;Micronesia
  649. &lt;/OPTION&gt;
  650.  
  651. &lt;OPTION Value=&#8221;MD&#8221;&gt;Moldavia
  652. &lt;/OPTION&gt;
  653.  
  654. &lt;OPTION Value=&#8221;MC&#8221;&gt;Monaco
  655. &lt;/OPTION&gt;
  656.  
  657. &lt;OPTION Value=&#8221;MN&#8221;&gt;Mongolia
  658. &lt;/OPTION&gt;
  659.  
  660. &lt;OPTION Value=&#8221;MS&#8221;&gt;Montserrat
  661. &lt;/OPTION&gt;
  662.  
  663. &lt;OPTION Value=&#8221;MA&#8221;&gt;Morocco
  664. &lt;/OPTION&gt;
  665.  
  666. &lt;OPTION Value=&#8221;MZ&#8221;&gt;Mozambique
  667. &lt;/OPTION&gt;
  668.  
  669. &lt;OPTION Value=&#8221;MM&#8221;&gt;Myanmar
  670. &lt;/OPTION&gt;
  671.  
  672. &lt;OPTION Value=&#8221;NA&#8221;&gt;Namibia
  673. &lt;/OPTION&gt;
  674.  
  675. &lt;OPTION Value=&#8221;NR&#8221;&gt;Nauru
  676. &lt;/OPTION&gt;
  677.  
  678. &lt;OPTION Value=&#8221;NP&#8221;&gt;Nepal
  679. &lt;/OPTION&gt;
  680.  
  681. &lt;OPTION Value=&#8221;NL&#8221;&gt;Netherlands
  682. &lt;/OPTION&gt;
  683.  
  684. &lt;OPTION Value=&#8221;AN&#8221;&gt;Netherlands Antilles
  685. &lt;/OPTION&gt;
  686.  
  687. &lt;OPTION Value=&#8221;NT&#8221;&gt;Neutral Zone
  688. &lt;/OPTION&gt;
  689.  
  690. &lt;OPTION Value=&#8221;NC&#8221;&gt;New Caledonia (French)
  691. &lt;/OPTION&gt;
  692.  
  693. &lt;OPTION Value=&#8221;NZ&#8221;&gt;New Zealand
  694. &lt;/OPTION&gt;
  695.  
  696. &lt;OPTION Value=&#8221;NI&#8221;&gt;Nicaragua
  697. &lt;/OPTION&gt;
  698.  
  699. &lt;OPTION Value=&#8221;NE&#8221;&gt;Niger
  700. &lt;/OPTION&gt;
  701.  
  702. &lt;OPTION Value=&#8221;NG&#8221;&gt;Nigeria
  703. &lt;/OPTION&gt;
  704.  
  705. &lt;OPTION Value=&#8221;NU&#8221;&gt;Niue
  706. &lt;/OPTION&gt;
  707.  
  708. &lt;OPTION Value=&#8221;NF&#8221;&gt;Norfolk Island
  709. &lt;/OPTION&gt;
  710.  
  711. &lt;OPTION Value=&#8221;KP&#8221;&gt;North Korea
  712. &lt;/OPTION&gt;
  713.  
  714. &lt;OPTION Value=&#8221;MP&#8221;&gt;Northern Mariana Islands
  715. &lt;/OPTION&gt;
  716.  
  717. &lt;OPTION Value=&#8221;NO&#8221;&gt;Norway
  718. &lt;/OPTION&gt;
  719.  
  720. &lt;OPTION Value=&#8221;OM&#8221;&gt;Oman
  721. &lt;/OPTION&gt;
  722.  
  723. &lt;OPTION Value=&#8221;PK&#8221;&gt;Pakistan
  724. &lt;/OPTION&gt;
  725.  
  726. &lt;OPTION Value=&#8221;PW&#8221;&gt;Palau
  727. &lt;/OPTION&gt;
  728.  
  729. &lt;OPTION Value=&#8221;PA&#8221;&gt;Panama
  730. &lt;/OPTION&gt;
  731.  
  732. &lt;OPTION Value=&#8221;PG&#8221;&gt;Papua New Guinea
  733. &lt;/OPTION&gt;
  734.  
  735. &lt;OPTION Value=&#8221;PY&#8221;&gt;Paraguay
  736. &lt;/OPTION&gt;
  737.  
  738. &lt;OPTION Value=&#8221;PE&#8221;&gt;Peru
  739. &lt;/OPTION&gt;
  740.  
  741. &lt;OPTION Value=&#8221;PH&#8221;&gt;Philippines
  742. &lt;/OPTION&gt;
  743.  
  744. &lt;OPTION Value=&#8221;PN&#8221;&gt;Pitcairn Island
  745. &lt;/OPTION&gt;
  746.  
  747. &lt;OPTION Value=&#8221;PL&#8221;&gt;Poland
  748. &lt;/OPTION&gt;
  749.  
  750. &lt;OPTION Value=&#8221;PF&#8221;&gt;Polynesia (French)
  751. &lt;/OPTION&gt;
  752.  
  753. &lt;OPTION Value=&#8221;PT&#8221;&gt;Portugal
  754. &lt;/OPTION&gt;
  755.  
  756. &lt;OPTION Value=&#8221;PR&#8221;&gt;Puerto Rico
  757. &lt;/OPTION&gt;
  758.  
  759. &lt;OPTION Value=&#8221;QA&#8221;&gt;Qatar
  760. &lt;/OPTION&gt;
  761.  
  762. &lt;OPTION Value=&#8221;RE&#8221;&gt;Reunion (French)
  763.  
  764. &lt;/OPTION&gt;
  765.  
  766. &lt;OPTION Value=&#8221;RO&#8221;&gt;Romania
  767. &lt;/OPTION&gt;
  768.  
  769. &lt;OPTION Value=&#8221;RU&#8221;&gt;Russian Federation
  770. &lt;/OPTION&gt;
  771.  
  772. &lt;OPTION Value=&#8221;RW&#8221;&gt;Rwanda
  773. &lt;/OPTION&gt;
  774.  
  775. &lt;OPTION Value=&#8221;GS&#8221;&gt;S. Georgia &amp; S. Sandwich Is.
  776. &lt;/OPTION&gt;
  777.  
  778. &lt;OPTION Value=&#8221;SH&#8221;&gt;Saint Helena
  779. &lt;/OPTION&gt;
  780.  
  781. &lt;OPTION Value=&#8221;KN&#8221;&gt;Saint Kitts &amp; Nevis Anguilla
  782. &lt;/OPTION&gt;
  783.  
  784. &lt;OPTION Value=&#8221;LC&#8221;&gt;Saint Lucia
  785. &lt;/OPTION&gt;
  786.  
  787. &lt;OPTION Value=&#8221;PM&#8221;&gt;Saint Pierre and Miquelon
  788. &lt;/OPTION&gt;
  789.  
  790. &lt;OPTION Value=&#8221;ST&#8221;&gt;Saint Tome (Sao Tome)
  791. &lt;/OPTION&gt;
  792.  
  793. &lt;OPTION Value=&#8221;VC&#8221;&gt;Saint Vincent &amp; Grenadines
  794. &lt;/OPTION&gt;
  795.  
  796. &lt;OPTION Value=&#8221;WS&#8221;&gt;Samoa
  797. &lt;/OPTION&gt;
  798.  
  799. &lt;OPTION Value=&#8221;SM&#8221;&gt;San Marino
  800. &lt;/OPTION&gt;
  801.  
  802. &lt;OPTION Value=&#8221;SA&#8221;&gt;Saudi Arabia
  803. &lt;/OPTION&gt;
  804.  
  805. &lt;OPTION Value=&#8221;SN&#8221;&gt;Senegal
  806. &lt;/OPTION&gt;
  807.  
  808. &lt;OPTION Value=&#8221;SC&#8221;&gt;Seychelles
  809. &lt;/OPTION&gt;
  810.  
  811. &lt;OPTION Value=&#8221;SL&#8221;&gt;Sierra Leone
  812. &lt;/OPTION&gt;
  813.  
  814. &lt;OPTION Value=&#8221;SG&#8221;&gt;Singapore
  815. &lt;/OPTION&gt;
  816.  
  817. &lt;OPTION Value=&#8221;SK&#8221;&gt;Slovak Republic
  818. &lt;/OPTION&gt;
  819.  
  820. &lt;OPTION Value=&#8221;SI&#8221;&gt;Slovenia
  821. &lt;/OPTION&gt;
  822.  
  823. &lt;OPTION Value=&#8221;SB&#8221;&gt;Solomon Islands
  824. &lt;/OPTION&gt;
  825.  
  826. &lt;OPTION Value=&#8221;SO&#8221;&gt;Somalia
  827. &lt;/OPTION&gt;
  828.  
  829. &lt;OPTION Value=&#8221;ZA&#8221;&gt;South Africa
  830. &lt;/OPTION&gt;
  831.  
  832. &lt;OPTION Value=&#8221;KR&#8221;&gt;South Korea
  833. &lt;/OPTION&gt;
  834.  
  835. &lt;OPTION Value=&#8221;ES&#8221;&gt;Spain
  836. &lt;/OPTION&gt;
  837.  
  838. &lt;OPTION Value=&#8221;LK&#8221;&gt;Sri Lanka
  839. &lt;/OPTION&gt;
  840.  
  841. &lt;OPTION Value=&#8221;SD&#8221;&gt;Sudan
  842. &lt;/OPTION&gt;
  843.  
  844. &lt;OPTION Value=&#8221;SR&#8221;&gt;Suriname
  845. &lt;/OPTION&gt;
  846.  
  847. &lt;OPTION Value=&#8221;SJ&#8221;&gt;Svalbard and Jan Mayen Is.
  848. &lt;/OPTION&gt;
  849.  
  850. &lt;OPTION Value=&#8221;SZ&#8221;&gt;Swaziland
  851. &lt;/OPTION&gt;
  852.  
  853. &lt;OPTION Value=&#8221;SE&#8221;&gt;Sweden
  854. &lt;/OPTION&gt;
  855.  
  856. &lt;OPTION Value=&#8221;CH&#8221;&gt;Switzerland
  857. &lt;/OPTION&gt;
  858.  
  859. &lt;OPTION Value=&#8221;SY&#8221;&gt;Syria
  860. &lt;/OPTION&gt;
  861.  
  862. &lt;OPTION Value=&#8221;TJ&#8221;&gt;Tadjikistan
  863. &lt;/OPTION&gt;
  864.  
  865. &lt;OPTION Value=&#8221;TW&#8221;&gt;Taiwan
  866. &lt;/OPTION&gt;
  867.  
  868. &lt;OPTION Value=&#8221;TZ&#8221;&gt;Tanzania
  869. &lt;/OPTION&gt;
  870.  
  871. &lt;OPTION Value=&#8221;TH&#8221;&gt;Thailand
  872. &lt;/OPTION&gt;
  873.  
  874. &lt;OPTION Value=&#8221;TG&#8221;&gt;Togo
  875. &lt;/OPTION&gt;
  876.  
  877. &lt;OPTION Value=&#8221;TK&#8221;&gt;Tokelau
  878. &lt;/OPTION&gt;
  879.  
  880. &lt;OPTION Value=&#8221;TO&#8221;&gt;Tonga
  881. &lt;/OPTION&gt;
  882.  
  883. &lt;OPTION Value=&#8221;TT&#8221;&gt;Trinidad and Tobago
  884. &lt;/OPTION&gt;
  885.  
  886. &lt;OPTION Value=&#8221;TN&#8221;&gt;Tunisia
  887. &lt;/OPTION&gt;
  888.  
  889. &lt;OPTION Value=&#8221;TR&#8221;&gt;Turkey
  890. &lt;/OPTION&gt;
  891.  
  892. &lt;OPTION Value=&#8221;TM&#8221;&gt;Turkmenistan
  893. &lt;/OPTION&gt;
  894.  
  895. &lt;OPTION Value=&#8221;TC&#8221;&gt;Turks and Caicos Islands
  896. &lt;/OPTION&gt;
  897.  
  898. &lt;OPTION Value=&#8221;TV&#8221;&gt;Tuvalu
  899. &lt;/OPTION&gt;
  900.  
  901. &lt;OPTION Value=&#8221;UG&#8221;&gt;Uganda
  902. &lt;/OPTION&gt;
  903.  
  904. &lt;OPTION Value=&#8221;UA&#8221;&gt;Ukraine
  905. &lt;/OPTION&gt;
  906.  
  907. &lt;OPTION Value=&#8221;AE&#8221;&gt;United Arab Emirates
  908. &lt;/OPTION&gt;
  909.  
  910. &lt;OPTION Value=&#8221;UK&#8221;&gt;United Kingdom
  911. &lt;/OPTION&gt;
  912.  
  913. &lt;OPTION Value=&#8221;US&#8221;&gt;United States
  914. &lt;/OPTION&gt;
  915.  
  916. &lt;OPTION Value=&#8221;UY&#8221;&gt;Uruguay
  917. &lt;/OPTION&gt;
  918.  
  919. &lt;OPTION Value=&#8221;UM&#8221;&gt;USA Minor Outlying Islands
  920. &lt;/OPTION&gt;
  921.  
  922. &lt;OPTION Value=&#8221;UZ&#8221;&gt;Uzbekistan
  923. &lt;/OPTION&gt;
  924.  
  925. &lt;OPTION Value=&#8221;VU&#8221;&gt;Vanuatu
  926. &lt;/OPTION&gt;
  927.  
  928. &lt;OPTION Value=&#8221;VE&#8221;&gt;Venezuela
  929. &lt;/OPTION&gt;
  930.  
  931. &lt;OPTION Value=&#8221;VN&#8221;&gt;Vietnam
  932. &lt;/OPTION&gt;
  933.  
  934. &lt;OPTION Value=&#8221;VG&#8221;&gt;Virgin Islands (British)
  935. &lt;/OPTION&gt;
  936.  
  937. &lt;OPTION Value=&#8221;VI&#8221;&gt;Virgin Islands (USA)
  938. &lt;/OPTION&gt;
  939.  
  940. &lt;OPTION Value=&#8221;WF&#8221;&gt;Wallis and Futuna Islands
  941. &lt;/OPTION&gt;
  942.  
  943. &lt;OPTION Value=&#8221;EH&#8221;&gt;Western Sahara
  944. &lt;/OPTION&gt;
  945.  
  946. &lt;OPTION Value=&#8221;YE&#8221;&gt;Yemen
  947. &lt;/OPTION&gt;
  948.  
  949. &lt;OPTION Value=&#8221;YU&#8221;&gt;Yugoslavia
  950. &lt;/OPTION&gt;
  951.  
  952. &lt;OPTION Value=&#8221;ZR&#8221;&gt;Zaire
  953. &lt;/OPTION&gt;
  954.  
  955. &lt;OPTION Value=&#8221;ZM&#8221;&gt;Zambia
  956. &lt;/OPTION&gt;
  957.  
  958. &lt;OPTION Value=&#8221;ZW&#8221;&gt;Zimbabwe
  959. &lt;/OPTION&gt;
  960.  
  961. &lt;OPTION VALUE=&#8221;&#8221; SELECTED&gt;&#8211;None&#8211;
  962. &lt;/OPTION&gt;
  963.  
  964. &lt;/SELECT&gt;
  965. &lt;input type=hidden name=_HIDDENlead_companycountry value=&#8221;&#8221;&gt;&lt;span CLASS=VIEWBOXNOBG&gt;&lt;font color=&#8221;red&#8221; &gt;*&lt;/font&gt;&lt;/span&gt;&lt;/SPAN&gt;
  966. &lt;/TD&gt;
  967. &lt;/TR&gt;
  968.  
  969. &lt;TR&gt;
  970. &lt;TD VALIGN=TOP &gt;&lt;SPAN ID=_Captlead_personphonenumber class=VIEWBOXCAPTION&gt;Phone Number:&lt;/SPAN&gt;
  971. &lt;BR&gt;&lt;SPAN ID=_Datalead_personphonenumber class=VIEWBOX &gt;&lt;input name=&#8221;lead_personphonenumber&#8221; type=&#8221;text&#8221; CLASS=EDIT ID=&#8221;lead_personphonenumber&#8221; value=&#8221;&#8221; size=&#8221;60&#8243; maxlength=20&gt;&lt;input type=hidden name=_HIDDENlead_personphonenumber value=&#8221;&#8221;&gt;&lt;/SPAN&gt;
  972. &lt;/TD&gt;
  973. &lt;/TR&gt;
  974.  
  975. &lt;TR&gt;
  976. &lt;TD width=&#8221;580&#8243; height=&#8221;50&#8243; VALIGN=TOP &gt;&lt;SPAN ID=_Captlead_personemail class=VIEWBOXCAPTION&gt;E-mail:&lt;/SPAN&gt;
  977. &lt;BR&gt;&lt;SPAN ID=_Datalead_personemail class=VIEWBOX &gt;&lt;input name=&#8221;lead_personemail&#8221; type=&#8221;text&#8221; CLASS=EDIT ID=&#8221;lead_personemail&#8221; value=&#8221;&#8221; size=&#8221;60&#8243; maxlength=30&gt;&lt;input type=hidden name=_HIDDENlead_personemail value=&#8221;&#8221;&gt;&lt;span CLASS=VIEWBOXNOBG&gt;&lt;font color=&#8221;red&#8221; &gt;*&lt;/font&gt;&lt;/span&gt;&lt;/SPAN&gt;
  978. &lt;/TD&gt;
  979. &lt;/TR&gt;
  980.  
  981. &lt;TD width=&#8221;580&#8243; height=&#8221;50&#8243; VALIGN=TOP &gt;&lt;SPAN ID=_Captlead_description class=VIEWBOXCAPTION&gt;Description:&lt;/SPAN&gt;
  982. (30 Max Characters)&lt;BR&gt;&lt;SPAN ID=_Datalead_description class=VIEWBOX &gt;&lt;input name=&#8221;lead_description&#8221; type=&#8221;text&#8221; CLASS=EDIT ID=&#8221;lead_description&#8221; value=&#8221;&#8221; size=&#8221;60&#8243; maxlength=30&gt;&lt;input type=hidden name=_HIDDENlead_description value=&#8221;&#8221;&gt;&lt;span CLASS=VIEWBOXNOBG&gt;&lt;font color=&#8221;red&#8221; &gt;*&lt;/font&gt;&lt;/span&gt;&lt;/SPAN&gt;
  983. &lt;/TD&gt;
  984. &lt;/TR&gt;
  985.  
  986. &lt;p&gt;&lt;TR&gt;
  987. &lt;TD width=&#8221;580&#8243; height=&#8221;175&#8243; VALIGN=TOP &gt;&lt;SPAN ID=_Captlead_details class=VIEWBOXCAPTION&gt;Details:&lt;/SPAN&gt;
  988. &lt;BR&gt;&lt;SPAN ID=_Datalead_details class=VIEWBOX &gt;&lt;textarea CLASS=EDIT name=&#8221;lead_details&#8221; rows=8 cols=50&gt;&lt;/TEXTAREA&gt;&lt;input type=hidden name=_HIDDENlead_details value=&#8221;&#8221;&gt;&lt;span CLASS=VIEWBOXNOBG&gt;&lt;font color=&#8221;red&#8221; &gt;*&lt;/font&gt;&lt;/span&gt;&lt;/SPAN&gt;
  989. &lt;/TD&gt;
  990. &lt;/TR&gt;
  991. &lt;/TABLE&gt;
  992.  
  993. &lt;input type=hidden name=_HIDDENlead_source value=&#8221;web&#8221;&gt;&lt;input type=&#8221;submit&#8221; value=&#8221;Save and Submit&#8221;&gt;&lt;input type=&#8221;hidden&#8221; name=&#8221;RuleID&#8221; id=&#8221;RuleID&#8221; value=&#8221;&#8221;&gt;
  994. &lt;/FORM&gt;
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