<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html>
<head>
<script language="javascript">
function validateForm( )
{
var frm = document.frmMain;
if(! ValidateEmail(frm.emailaddr) )
{
return false;
}
if(frm.firstname.value == "")
{
alert('Must fill in your first name!');
frm.firstname.focus();
return false;
}
return true;
}
function echeck(str) {
var at="@"
var dot="."
var lat=str.indexOf(at)
var lstr=str.length
var ldot=str.indexOf(dot)
if (str.indexOf(at)==-1){
alert("Invalid E-mail ID")
return false
}
if (str.indexOf(at)==-1 || str.indexOf(at)==0 || str.indexOf(at)==lstr){
alert("Invalid E-mail ID")
return false
}
if (str.indexOf(dot)==-1 || str.indexOf(dot)==0 || str.indexOf(dot)==lstr){
alert("Invalid E-mail ID")
return false
}
if (str.indexOf(at,(lat+1))!=-1){
alert("Invalid E-mail ID")
return false
}
if (str.substring(lat-1,lat)==dot || str.substring(lat+1,lat+2)==dot){
alert("Invalid E-mail ID")
return false
}
if (str.indexOf(dot,(lat+2))==-1){
alert("Invalid E-mail ID")
return false
}
if (str.indexOf(" ")!=-1){
alert("Invalid E-mail ID")
return false
}
return true
}
function ValidateEmail(emailID){
if ((emailID.value==null)||(emailID.value=="")){
alert("Please Enter your Email ID")
emailID.focus()
return false
}
if (echeck(emailID.value)==false){
emailID.value=""
emailID.focus()
return false
}
return true
}
</script>
<title>Subscriber to {listname}</title>
<style type="text/css">
.main { font-family: Arial,Helvetica,sans-serif;
font-size: 12px;
}
</style>
</head>
<body style="color: rgb(0, 0, 0); background-color: rgb(255, 255, 255);"
class="main" link="#000099" alink="#000099" vlink="#625b99">
<div style="text-align: center;"><span style="font-weight: bold;">Subscribe
to {listname} today!</span><br>
</div>
<form name="frmMain" method="post" action="{form_action}">
<table class="main"
style="text-align: center; margin-left: 0px; margin-right: auto;"
align="center" border="0" bgcolor="#000000" cellspacing="1">
<tr bgcolor="#FFFFFF">
<td>*E-Mail Address:</td>
<td>
<input name="emailaddr" size="30" type="text" value="{default_email}"></td>
</tr>
<tr bgcolor="#FFFFFF">
<td> *First Name: </td>
<td>
<input name="firstname" size="30" type="text" value="{default_firstname}"></td>
</tr>
<tr bgcolor="#FFFFFF">
<td> Last Name: </td>
<td>
<input name="lastname" size="30" type="text" value="{default_lastname}"></td>
</tr>
<tr bgcolor="#FFFFFF">
<td> City: </td>
<td>
<input name="userfield1" size="30" type="text" value="{default_userfield1}"></td>
</tr>
<tr bgcolor="#FFFFFF">
<td>State: </td>
<td>
<select name="userfield2">
<option value="">N/A</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AS">American
Samoa</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District
Of Columbia</option>
<option value="FM">Federated
States Of Micronesia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="GU">Guam</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MH">Marshall
Islands</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New
Hampshire</option>
<option value="NJ">New
Jersey</option>
<option value="NM">New
Mexico</option>
<option value="NY">New
York</option>
<option value="NC">North
Carolina</option>
<option value="ND">North
Dakota</option>
<option value="MP">Northern
Mariana Islands</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PW">Palau</option>
<option value="PA">Pennsylvania</option>
<option value="PR">Puerto
Rico</option>
<option value="RI">Rhode
Island</option>
<option value="SC">South
Carolina</option>
<option value="SD">South
Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VI">Virgin
Islands</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West
Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
</td>
</tr>
<tr align="center" bgcolor="#FFFFFF">
<td colspan="2">
<input value="Join mailing list"
onclick="return validateForm( )" type="submit"></td>
</tr>
</table>
</form>
</body>
</html>