<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=windows-1252">
</head>
<body>
<p align="center">
<img src="http://64.239.108.244/advert/my_ad_graphic1_12_06.jpg" width="500" height="433"></p>
<form name="form1" action="http://64.239.108.244/advert/form_submit.asp" method="post">
<table cellSpacing="0" cellPadding="0" align="center" border="0">
<tr><c><a>Or To Be Contacted, Please Complete Form<a><c>
<td>
<table cellSpacing="0" cellPadding="10" width="100%" border="0">
<tr>
<td>
<table cellSpacing="0" cellPadding="2" width="100%" border="0">
<tr>
<td><font face="Arial, Helvetica, sans-serif" size="-1">Your
Name</font></td>
<td><font face="Arial, Helvetica, sans-serif" size="-1">
<input name="name" size="20"> </font></td>
</tr>
<tr>
<td><font face="Arial, Helvetica, sans-serif" size="-1">Website
Address</font></td>
<td><font face="Arial, Helvetica, sans-serif" size="-1">
<input name="website" size="20"> </font></td>
</tr>
<tr>
<td><font face="Arial, Helvetica, sans-serif" size="-1">Phone
Number</font></td>
<td><font face="Arial, Helvetica, sans-serif" size="-1">
<input name="phone" size="20"> </font></td>
</tr>
<tr>
<td><font face="Arial, Helvetica, sans-serif" size="-1">Cell Phone</font></td>
<td><font face="Arial, Helvetica, sans-serif" size="-1">
<input name="cell" size="20"> </font></td>
</tr>
<tr>
<td><font face="Arial, Helvetica, sans-serif" size="-1">Best time
to call</font></td>
<td><font face="Arial, Helvetica, sans-serif" size="-1">
<input name="best_time_to_call" size="20"> </font></td>
</tr>
<tr>
<td><font face="Arial, Helvetica, sans-serif" size="-1">E-Mail</font></td>
<td><font face="Arial, Helvetica, sans-serif" size="-1">
<input name="email" size="20"> </font></td>
</tr>
<tr>
<td><font face="Arial, Helvetica, sans-serif" size="-1"> </font></td>
<td><font face="Arial, Helvetica, sans-serif" size="-1">
<input type="submit" value="Submit" name="Submit"> </font></td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</form>
<table cellSpacing="0" cellPadding="2" width="100%" bgColor="#006699" border="0">
<tr>
<td> </td>
</tr>
</table>
<p align="center">
<img src="http://64.239.108.244/advert/1.gif" width="180" height="47"></p>
<p align="center">
<font face="Arial, Helvetica, sans-serif" color="#003399" size="1">You are
receiving this message as an opt-in subscriber to <br>
PathEmail.com or one of our marketing partners. </font></p>
<p align="center">
<font face="Arial, Helvetica, sans-serif" color="#003399" size="1">If you no
longer wish to receive further offers, please send an email with discontinue to:
<a href="mailto:su...@pa...">su...@pa...</a></font></p>
<p align="center"><font face="Arial" color="#000080" size="1">Path Email</font><font face="Arial, Helvetica, sans-serif" color="#003399" size="1"><br>
27 Russel Ave <br>
Edgewater, NJ 07020 </font></p>
<p> </p>
</body>
</html>
|
