Online application form

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" background="04a085a3.jpg"> <div> <FONT SIZE="6" COLOR="#FFFFFF" FACE="Arial" ><B>SWIPEMUSIC.COM</B></FONT><B>    </B><B> </B></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Whats Happening?"><U>What's Happening?</U></A>   |   <A HREF="id19.htm" TARGET="_top" TITLE="Events"><U>Events</U></A>   |   <A HREF="id20.htm" TARGET="_top" TITLE="Panachea"><U>Panachea</U></A>   |   <A HREF="id24.htm" TARGET="_top" TITLE="Newsletter"><U>Newsletter</U></A>   |   <A HREF="id27.htm" TARGET="_top" TITLE="swipemusics myspace"><U>swipemusics myspace</U></A>   |   <A HREF="id32.htm" TARGET="_top" TITLE="Music Ads Wanted/Offered"><U>Music Ads Wanted/Offered</U></A>   |   <B>Online application form</B>   |   <A HREF="id22.htm" TARGET="_top" TITLE="See hear 20052006"><U>See hear 2005-2006</U></A>   |   <A HREF="id31.htm" TARGET="_top" TITLE="Links"><U>Links</U></A>   |   <A HREF="id21.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A>   |   <A HREF="id30.htm" TARGET="_top" TITLE="Onine Guitar Lessons"><U>Onine Guitar Lessons</U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="History"><U>History</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFFFFF" TEXT="#080000" background="04bd2e83.jpg"> <div> Please fill out this form to apply to be on one of our projects. Be sure to state  Your area of interest i.e steel pans - rehearsal space - guitar lessons - recording etc etc</div> <bR> <bR> <bR> <div> Registered Charity: 1107921</div> <bR> </td> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>Online application form</I></div> <div>  <form action="http://csbmail.globalscape.com/cgi-bin/csbmail/csbmail.pl" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="FirstName,LastName,Email,Company,Address1,Address2,City,State,Zip,Phone,MailingList,[Custom1],[Custom2],Comments"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thankyou for your interest we will contact you soon."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="A request form was submitted"><input type="hidden" name="tlx_EmailTo" value="webquery@swipemusic.com"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">First Name:<br> <input type="text" name="FirstName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Last Name:<br> <input type="text" name="LastName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">School/College:<br> <input type="text" name="Company" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Your Address :<br> <input type="text" name="Address1" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 2:<br> <input type="text" name="Address2" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Town:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">County:<br> <input type="text" name="State" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Postcode:<br> <input type="text" name="Zip" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td> <input type="checkbox" name="MailingList" value="yes"> Add me to your mailing list</td> </tr> <tr> <td align="left">Date of Birth:<br> <input type="text" name="[Custom1]" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Parents name and Contact number if under 16:<br> <input type="text" name="[Custom2]" size="30" maxlength="100"></td> </tr> <tr> <td align="left">How Can We help you?:<br> <textarea name="Comments" rows="5" cols="30"></textarea></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> </td> </tr></table></body>