PayneLess Designs - Freedback Form

<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><head>
<title>Freedback Form</title>
<meta http-equiv="content-type" content="text/html; charset=utf-8" />
<meta name="created" content="Thu, 06 Sep 2012 01:15:16 GMT" />
<meta name="description" content="" />
<meta name="keywords" content="" />
<style type="text/css">
form input, table input {
background: #000;
color: #fff;
}
</style>
</head><body>
<!-- Begin Freedback Form -->
<form enctype="multipart/form-data" method="post" action="http://www.freedback.com/mail.php" accept-charset="UTF-8">
<div>
<input type="hidden" name="acctid" id="acctid" value="ihdi4yb4ixkqnpdg" />
<input type="hidden" name="formid" id="formid" value="1124528" />
</div>
<table cellspacing="5" cellpadding="12" border="0" summary="">
<tr>
<td valign="top"><strong>XX</strong></td>

<td valign="top"><input type="text" name="name" id="name" size="40" value="" /></td>
</tr>

<tr>
<td valign="top"><strong>XX</strong></td>

<td valign="top"><input type="text" name="email" id="email" size="40" value="" /></td>
</tr>

<tr>
<td colspan="2" align="center"><input type="submit" value=" Submit Form " /></td>
</tr>
</table>
</form>
<p style="text-align: center; font-family: arial, helvetica; font-size: 0.8em; font-weight: bold;">This <a href="http://www.freedback.com">contact form</a> was created by Freedback.</p>
<!-- End Freedback Form -->
</body></html>
<!-- http://www.freedback.com/faq_existingform.php -->