From: Subject: < Date: Thu, 24 Aug 2006 22:48:44 -0500 MIME-Version: 1.0 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Content-Location: file://C:\Documents and Settings\Naomi\MY DOCUMENTS\PETSCAPADES\BUSINESS Forms\Revised August 06 Online Booking Form.htm X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.2962 <

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      = <input=20 type=3D"hidden" name=3D"acctid" id=3D"acctid" value=3D"vo4dl0rg419lctr5" = />

      = <input=20 type=3D"hidden" name=3D"formid" id=3D"formid" value=3D"105387" />

      = <input=20 type=3D"hidden" name=3D"required_vars" id=3D"required_vars"=20 value=3D"name,email,field-454db64af750d43,field-ae81fae2a133091,field-e7e= b9e62b355977,field-305508592a0ef46"=20 />

      = <table=20 cellspacing=3D"10" cellpadding=3D"10" border=3D"0">

           =20 <tr>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <strong>Name:</strong>

           &nbs= p;     =20 </td>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <input type=3D"text" name=3D"name" id=3D"name" size=3D"40" = value=3D"" />

           &nbs= p;           =20

           &nbs= p;     =20 </td>

           =20 </tr>

           =20 <tr>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <strong>Email Address:</strong>

           &nbs= p;     =20 </td>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <input type=3D"text" name=3D"email" id=3D"email" size=3D"40" = value=3D""=20 />

           &nbs= p;           =20

           &nbs= p;     =20 </td>

           =20 </tr>

           =20 <tr>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <strong>Which Petscapades services are you interested=20 in?</strong>

           &nbs= p;     =20 </td>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <input type=3D"checkbox" name=3D"field-454db64af750d43[]"=20 id=3D"field-454db64af750d43[]" value=3D"Boarding" /> = Boarding<br/>

           &nbs= p;           =20 <input type=3D"checkbox" name=3D"field-454db64af750d43[]"=20 id=3D"field-454db64af750d43[]" value=3D"Day Care" /> Day = Care<br/>

           &nbs= p;           =20 <input type=3D"checkbox" name=3D"field-454db64af750d43[]"=20 id=3D"field-454db64af750d43[]" value=3D"Training" /> = Training<br/>

           &nbs= p;           =20 <input type=3D"checkbox" name=3D"field-454db64af750d43[]"=20 id=3D"field-454db64af750d43[]" value=3D"Special Services" /> Special=20 Services<br/>

           &nbs= p;           =20

           &nbs= p;     =20 </td>

           =20 </tr>

           =20 <tr>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <strong>During which month do you need these=20 services?</strong>

           &nbs= p;     =20 </td>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <select name=3D"field-ae81fae2a133091"=20 id=3D"field-ae81fae2a133091">

           &nbs= p;            = ;     =20 <option value=3D"January">January</option>

           &nbs= p;            = ;     =20 <option value=3D"February">February</option>

           &nbs= p;            = ;     =20 <option value=3D"March">March</option>

           &nbs= p;            = ;     =20 <option value=3D"April">April</option>

           &nbs= p;            = ;     =20 <option value=3D"May">May</option>

           &nbs= p;            = ;     =20 <option value=3D"June">June</option>

           &nbs= p;            = ;     =20 <option value=3D"July">July</option>

           &nbs= p;            = ;     =20 <option value=3D"August">August</option>

           &nbs= p;            = ;     =20 <option value=3D"September">September</option>

           &nbs= p;            = ;     =20 <option value=3D"October">October</option>

           &nbs= p;            = ;     =20 <option value=3D"November">November</option>

           &nbs= p;            = ;     =20 <option value=3D"December">December</option>

           &nbs= p;           =20 </select>

           &nbs= p;           =20

           &nbs= p;     =20 </td>

           =20 </tr>

           =20 <tr>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <strong>How many days do you anticipate needing the = selected=20 service(s)?</strong>

           &nbs= p;     =20 </td>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <select name=3D"field-e7eb9e62b355977"=20 id=3D"field-e7eb9e62b355977">

           &nbs= p;            = ;     =20 <option value=3D"1">1</option>

           &nbs= p;            = ;     =20 <option value=3D"2-3">2-3</option>

           &nbs= p;            = ;     =20 <option value=3D"3-5">3-5</option>

           &nbs= p;            = ;     =20 <option value=3D"5-7">5-7</option>

           &nbs= p;            = ;     =20 <option value=3D"7+">7+</option>

           &nbs= p;           =20 </select>

           &nbs= p;           =20

           &nbs= p;     =20 </td>

           =20 </tr>

           =20 <tr>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <strong>How many pets will you be reserving services=20 for?</strong>

           &nbs= p;     =20 </td>

           &nbs= p;     =20 <td valign=3D"top">

           &nbs= p;           =20 <select name=3D"field-305508592a0ef46"=20 id=3D"field-305508592a0ef46">

           &nbs= p;            = ;     =20 <option value=3D"1">1</option>

           &nbs= p;            = ;     =20 <option value=3D"2">2</option>

           &nbs= p;            = ;     =20 <option value=3D"3 or more">3 or more</option>

           &nbs= p;           =20 </select>

           &nbs= p;           =20

           &nbs= p;     =20 </td>

           =20 </tr>

           =20 <tr>

           &nbs= p;     =20 <td colspan=3D"2" align=3D"center">

           &nbs= p;           =20 <input type=3D"submit" value=3D" Submit Form " />

           &nbs= p;     =20 </td>

           =20 </tr>

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