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   <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<script language="JavaScript">
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<body text="#000000" bgcolor="#FFFFCC" link="#0000EE" vlink="#551A8B" alink="#FF0000">

<h3>Thanks for visiting our website.</h3>
Your information will be shipped by regular ground service at no cost to you.
<form name="form"
method="post"
action="mailto:listmanager_stock@yahoo.com?SUBJECT=form"
onSubmit="return validate_form()">

<font face="Verdana">Name:</font>&nbsp;<input TYPE="TEXT" NAME="name" VALUE="" SIZE="30" 
MAXLENGTH="30">
<br><font face="Verdana">Address:</font><input TYPE="TEXT" NAME="address" VALUE="" SIZE="30"> <font face="Verdana"><br>
City:</font><input TYPE="TEXT" NAME="city" ID="city" SIZE="20"><font face="Verdana">State:</font>
<select name="state" size="1" id="state">
<option value="AK">AK&nbsp;</option>
<option value="AR">AR&nbsp;</option>
<option value="AZ">AZ&nbsp;</option>
<option value="CA">CA&nbsp;</option>
<option value="CO">CO&nbsp;</option>
<option value="CT">CT&nbsp;</option>
<option value="DC">DC&nbsp;</option>
<option value="DE">DE&nbsp;</option>
<option value="FL">FL&nbsp;</option>
<option value="GA">GA&nbsp;</option>
<option value="HI">HI&nbsp;</option>
<option value="IA">IA&nbsp;</option>
<option value="ID">ID&nbsp;</option>
<option value="IL">IL&nbsp;</option>
<option value="IN">IN&nbsp;</option>
<option value="KS">KS&nbsp;</option>
<option value="KY">KY&nbsp;</option>
<option value="LA">LA&nbsp;</option>
<option value="MA">MA&nbsp;</option>
<option value="MD">MD&nbsp;</option>
<option value="ME">ME&nbsp;</option>
<option value="MI">MI&nbsp;</option>
<option value="MN">MN&nbsp;</option>
<option value="MO">MO&nbsp;</option>
<option value="MS">MS&nbsp;</option>
<option value="MT">MT&nbsp;</option>
<option value="NC">NC&nbsp;</option>
<option value="ND">ND&nbsp;</option>
<option value="NE">NE&nbsp;</option>
<option value="NH">NH&nbsp;</option>
<option value="NJ">NJ&nbsp;</option>
<option value="NM">NM&nbsp;</option>
<option value="NV">NV&nbsp;</option>
<option value="NY">NY&nbsp;</option>
<option value="OH">OH&nbsp;</option>
<option value="OK">OK&nbsp;</option>
<option value="OR">OR&nbsp;</option>
<option value="PA">PA&nbsp;</option>
<option value="RI">RI&nbsp;</option>
<option value="SC">SC&nbsp;</option>
<option value="SD">SD&nbsp;</option>
<option value="TN">TN&nbsp;</option>
<option value="TX">TX&nbsp;</option>
<option value="UT">UT&nbsp;</option>
<option value="VA">VA&nbsp;</option>
<option value="VT">VT&nbsp;</option>
<option value="WA">WA&nbsp;</option>
<option value="WI">WI&nbsp;</option>
<option value="WV">WV&nbsp;</option>
</select>
<font face="Verdana">Zip<input TYPE="TEXT" NAME="zip" VALUE="" SIZE="5" 
MAXLENGTH="5"></font>
<br><br>
<font face="Verdana">Enter a <b>VALID</b> Email Address:</font><input type="TEXT" name="email" value="" size="30" 
maxlength="30">
<br><font face="Verdana">to receive <b>ONE BONUS REPORT:</b></font>
<br> <input type=checkbox name=health value=h> <font face="Verdana">Health & Fitness Report</font>
<br> <input type=checkbox name=stock value=s> <font face="Verdana">Stock Tips and IPOs</font>
<br> <input type=checkbox name=credit value=c> <font face="Verdana">Get a Credit Card Regardless of Past History</font>
<br> <input type=checkbox name=money value=m> <font face="Verdana">Insiders Guide to Money Making Programs</font>
<br> <input type=checkbox name=travel value=t> <font face="Verdana">Underbooked Vacations & Special Travel Discounts</font>
<br> <input type=checkbox name=relate value=r> <font face="Verdana">Relationships & Personal Growth</font>

<p><input type="Submit" value="Submit Form" name="Submit">&nbsp;<input 
type="Reset" value="Clear Form" name="Reset"></blockquote>

<p><br></form>
<font color="#FFFFCC">

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