Team:GeorgiaTech/Contact

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<div id="container"><div id="header">[[Image:Bannecontact.jpg|965px|logo]]
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<!-- Form header and Send-To Information -->
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<!-- Begin Response-O-Matic Form -->
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<form method="post" action="/Team:GeorgiaTech">
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<!-- DO NOT EDIT YOUR FORM HERE, PLEASE LOG IN AND EDIT AT RESPONSE-O-MATIC.COM -->
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<p><!-- Form header and Send-To Information --> <input type="hidden" name="mform-email" value="GT.IGEM@gmail.com"> <input type="hidden" name="mform-subject" value="Website Response"> <input type="hidden" name="mform-response" value="https://2010.igem.org/Team:GeorgiaTech/Contact"> <input type="hidden" name="mform-encoding" value="text"></p>
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<form enctype="multipart/form-data" method="post" action="http://www.response-o-matic.com/mail.php" accept-charset="UTF-8">
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<div>
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<input type="hidden" name="acctid" id="acctid" value="rnnod0docj83bji3" />
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<td colspan="2"><span class="c1"><input type="text" name="URL" size="17" value="http://"> :Your Website<br>
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<input type="hidden" name="formid" id="formid" value="819611" />
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<input type="text" name="user" size="17"> :Your Name<br>
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<input type="hidden" name="required_vars" id="required_vars" value="name,email,field-0c88c2b1da15928,field-d627c09924aa95b" />
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<input type="text" name="email" size="17"> :Your E-mail</span></td>
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<strong>Name:</strong>
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<option selected>Please Select One</option>
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</td>
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<option>GA Tech Institution</option>
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<td valign="top">
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<option>Company</option>
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<input type="text" name="name" id="name" size="40" value="" />
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<option>Professor</option>
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<option>Student</option>
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<option>Other</option>
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<strong>Email Address:</strong>
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<td colspan="2"><span class="c2"><input type="checkbox" name="liked it" value="sendme" checked> I found this website useful<br>
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</td>
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<input type="checkbox" name="disliked it" value="sendme"> I did not find this website useful<br></span>  
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<td valign="top">
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<textarea cols="20" rows="10">
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<input type="text" name="email" id="email" size="40" value="" />
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Please type your comments or questions here.
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</textarea>
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</td>
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<br>
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<div class="c3"><input name="redirect" type="hidden" value="GT.IGEM@gmail.com"> <input name="NEXT_URL" type="hidden" value="GT.IGEM@gmail.com"> <input type="submit" value="Send"> <input type="reset" value="Clear"></div>
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<td valign="top">
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<strong>Your Website:</strong>
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</td>
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<td valign="top">
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<input type="text" name="field-cd1078bce9f71c2" id="field-cd1078bce9f71c2" size="40" value="" />
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<td valign="top">
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<strong>Please Select One:</strong>
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<select name="field-0c88c2b1da15928" id="field-0c88c2b1da15928">
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<option value="Student">Student</option>
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<option value="Professor">Professor</option>
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<option value="Company">Company</option>
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<option value="Other">Other</option>
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</select>
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</tr>
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<tr>
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<td valign="top">
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<strong>Did you find this website helpful?</strong>
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</td>
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<td valign="top">
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<input type="checkbox" name="field-d627c09924aa95b[]" id="field-d627c09924aa95b_0" value="Yes" /> Yes<br/>
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<input type="checkbox" name="field-d627c09924aa95b[]" id="field-d627c09924aa95b_1" value="No" /> No<br/>
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</td>
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</tr>
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<tr>
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<td valign="top">
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<strong>Please leave any comments or questions.</strong>
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<td valign="top">
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<textarea name="field-5809a1c5b4c7e2c" id="field-5809a1c5b4c7e2c" rows="6" cols="40"></textarea>
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</td>
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<td colspan="2" align="center">
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<input type="submit" value=" Submit Form " />
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</table>
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</form>
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<br><center><font face="Arial, Helvetica" size="1"><b>
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<a href="http://www.response-o-matic.com">Click here</a> to create your own form.
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</b></font></center>
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<!-- End Response-O-Matic Form -->
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<!-- ** END OF FORM ** --></form>
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<hr>
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<img src="https://static.igem.org/mediawiki/2010/a/a2/Sponserslogo.jpg" alt="sponsors" width="970" border="0" usemap="#Map3" />
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</body>
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Latest revision as of 02:40, 28 October 2010

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