Category Archives: Uncategorized

Now 100% Organic!

<form action=”lmsform.php” method=”post” name=”form” id=”form”>
<input type=”hidden” name=”config” value=”0″ />
<table width=”100%” border=”0″ cellspacing=”0″ cellpadding=”0″>
<tr>
<td colspan=”2″><div align=”center”>
<p align=”left”>&nbsp;</p>
</div></td>
</tr>
<tr valign=”top”>
<td width=”34%”><span>FIRST NAME:</span><br />
<input name=”FirstName” type=”text” id=”FirstName” value=””/></td>
<td width=”66%”><span>LAST NAME:</span><span></span><br>
<input name=”LastName” type=”text” id=”LastName” value=””/></td>
</tr>
<tr valign=”top”>
<td colspan=”2″>&nbsp;</td>
</tr>
<tr valign=”top”>
<td><span>*</span><span>EMAIL</span>:<br />
<input type=”text” name=”Email” value=”” /></td>
<td><span><span>*CONFIRM EMAIL</span>:<br>
<input name=”ConfirmEmail” type=”text” id=”ConfirmEmail” value=””/>
</span></td>
</tr>
<tr valign=”top”>
<td colspan=”2″>&nbsp;</td>
</tr>
<tr valign=”top”>
<td colspan=”2″>REASON FOR MESSAGE: </td>
</tr>
<tr valign=”top”>
<td colspan=”2″><select name=”Reason” id=”Reason”>
<option>General Information</option>
<option>Bulk/Wholesale Orders</option>
<option>Affiliate Program</option>
<option>Sales</option>
<option>Customer Support</option>
</select></td>
</tr>
<tr valign=”top”>
<td colspan=”2″>&nbsp;</td>
</tr>
<tr valign=”top”>
<td colspan=”2″><p>COMMENTS:<br>
<textarea name=”Comments” cols=”50″ rows=”10″ id=”Comments”></textarea>
</p>                                </td>
</tr>
<tr>
<td colspan=”2″>&nbsp;</td>
</tr>
<tr>
<td colspan=”2″>&nbsp;</td>
</tr>
<tr>
<td colspan=”2″><p>
<input type=”submit” name=”submit” value=”Submit” />
<input type=”reset” name=”Reset” value=”Clear Form” />
</p>
<p><span>*Required<br>
</span></p></td>
</tr>
</table>
</form>