This form is for genuine concerns only. Do not send ads through this form as they <br />
will be deleted without being read. Your IP address is logged when you send a message<br /> 
and you will be reported for spamming!<br />
<br />
<br />
<!-- you can include your sites header above if you like -->
<!-- if you want to use basic JavaScript validation, keep the JS file call below -->
<script src="validation.js"></script>
<script>
// SPECIFY ALL REQUIRED FIELDS AND
// SEE validation.js for other options
required.add('fullname', 'NOT_EMPTY');
required.add('email', 'EMAIL');
required.add('comments', 'NOT_EMPTY');
required.add('answer_out', 'NUMERIC');
</script>
<link rel="stylesheet" type="text/css" href="form_style.css" />


<form name="fcform2" method="post" action="process_form.php" onsubmit="return validate.check()">
<div id="fcf2">
<h3>Contact Us Form</h3>
<p>All fields marked with <em>*</em> are required.</p>

<div class="r">
<label for="fullname" class="req">Full Name: <em>*</em></label>
<span class="f">
<input type="text" name="fullname" size="40" id="fullname" onBlur="trim('fullname')">
</span>
</div>

<div class="r">
<label for="email" class="req">Email Address: <em>*</em></label>
<span class="f">
<input type="text" name="email" size="40" id="email" onBlur="trim('email')">
</span>
</div>

<div class="r">
<label for="phone">Telephone: </label>
<span class="f">
<input type="text" name="phone" size="40" id="phone" onBlur="trim('phone')">
</span>
</div>

<div class="r">
<label for="comments" class="req">Comments: <em>*</em></label>
<span class="f">
<textarea cols="30" rows="8" name="comments" id="comments" onBlur="trim('comments')"></textarea>
</span>
</div>

<!-- the section below MUST remain for the magic to work -->
<!-- although feel free to change the style / layout -->
<div class="r">
<label for="quest" class="req">21 plus 0? <em>*</em></label>
<span class="f">
<input type="text" name="answer_out" size="6" id="answer_out" onBlur="trim('answer_out')"> &nbsp;

<!-- the link below MUST remain if you have not purchased a license -->
Spam prevention <a href="http://www.freecontactform.com/" target="_blank" title="Contact Form Script">Contact Form</a> question.
<!-- link above MUST remain if you have not purchased a license -->

</span>
</div>
<!-- section above must remain -->


<div class="sp">&nbsp;</div>

<p align="center">
<input type="submit" value="Submit">
<br />
</p>
</div>

<!-- the 2 hidden fields below must REMAIN for the magic to work -->
        <input type="hidden" name="answer_p" value="Wpn*">
        <input type="hidden" name="enc" value="WpsEWms9WmyDXmO7::umRTvmu9Pd4CueAa">
<!-- above 2 hidden fields MUST remain -->

</form>

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