Page details

User:
Dir:: .
File:: feedback.html
Title:
Issue:
Parent:: itd

General File Dir Title Issue Section

Main Text

<div style="background: #FFD700 url('/gif/dtr.gif') no-repeat top right; margin: 0 2.5%; padding: 0;"><div style="text-align: center; display: block; margin: 0; background: url('/gif/dbl.gif') no-repeat bottom left; padding: 0 0.125em;">
<br>
<h1>Feedback Form</h1>
</ul><hr style="visibility: hidden; height: 0; padding: 0; margin: 0;">
</div></div>
<FORM NAME="UMD_Feed_Back_Portal_Form" METHOD="POST" ACTION="/cgi-bin/generic_mail_list">
   <INPUT NAME="recipient" TYPE=hidden VALUE="gramadan@umd.com.au">
   <INPUT NAME="subject" TYPE=hidden VALUE="Web Feedback">
   <INPUT NAME="redirect" TYPE=hidden VALUE="http://www.umd.com.au/solutions/thanks.html">
   <TABLE BORDER="0" CELLSPACING="8" CELLPADDING="0">
     <TR>
       <TD>Name:</TD>
       <TD COLSPAN="3"><INPUT NAME="Name" TYPE=Text SIZE="50" MAXLENGTH="60"></TD>
     </TR>
     <TR>
       <TD>Title:</TD>
       <TD COLSPAN="3"><INPUT NAME="Title" TYPE=Text SIZE="50" MAXLENGTH="50"></TD>
     </TR>
     <TR>
       <TD>Company:</TD>
       <TD COLSPAN="3"><INPUT NAME="Company" TYPE=Text SIZE="50" MAXLENGTH="80"></TD>
     </TR>
     <TR>
       <TD>Address:</TD>
       <TD COLSPAN="3"><INPUT NAME="Address" TYPE=Text SIZE="50" MAXLENGTH="120"></TD>
     </TR>
     <TR>
       <TD>Tel:</TD>
       <TD><INPUT NAME="Telephone" TYPE=Text SIZE="20" MAXLENGTH="30"></TD>
       <TD>Fax:</TD>
       <TD><INPUT NAME="Fax" TYPE=Text SIZE="20" MAXLENGTH="30"></TD>
     </TR>
     <TR>
       <TD>Email:</TD>
       <TD COLSPAN="3"><INPUT NAME="Email" TYPE=Text SIZE="50" MAXLENGTH="60"></TD>
     <TR>
       <TD>Comments:</TD>
       <TD COLSPAN="3"><TEXTAREA NAME="Comments" ROWS=6 COLS=43></TEXTAREA></TD>
     </TR>
     <TR>
       <TD> &nbsp; </TD>
       <TD COLSPAN="3"><INPUT NAME="Send" TYPE=Submit VALUE="Send it in">  <INPUT NAME="Send" TYPE=Reset VALUE="Start again"></TD>
     </TR>
   </TABLE>
 </FORM>
 <a href="thanks.html"></a>
<br><br>
	</div>

Menu Text

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Information

Name:
Title:
Company:
Address:
Tel:		Fax:
Email:
Comments: