Location: PHPKode > scripts > Free Contact Form > Contact/contact1.php
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<title>Contact Form</title>
<style type="text/css">
<!--
body {
	margin-left: 0px;
	margin-top: 0px;
	margin-right: 0px;
	margin-bottom: 0px;
}
-->
</style>
<link href="style/contact.css" rel="stylesheet" type="text/css" />
</head>

<body>
<table width="75%" border="0" align="center" cellpadding="0" cellspacing="0" background="images/bg.jpg" style=" border-left:1px solid #7f7f7f; border-right:1px solid #7f7f7f; border-bottom:1px solid #7f7f7f; ">
  
  <tr>
    <td colspan="10"><img src="images/logo.jpg" width="179" height="80" /></td>
  </tr>
  
  <tr>
    <td colspan="2">&nbsp;</td>
    <td colspan="8">&nbsp;</td>
  </tr>
  <tr>
    <td width="2%" bgcolor="#EDEEFC" style="border-bottom:1px solid #cccccc; border-top:1px solid #cccccc">&nbsp;</td>
    <td width="22%" bgcolor="#EDEEFC" style="border-bottom:1px solid #cccccc;border-top:1px solid #cccccc"><b class="emailtxt">Contact Us </b></td>
    <td colspan="8" bgcolor="#EDEEFC" style="border-bottom:1px solid #cccccc;border-top:1px solid #cccccc">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td colspan="8">&nbsp;</td>
  </tr>
  
  <tr>
    <td colspan="2">&nbsp;</td>
    <td width="26%" valign="top"><span class="text">Name: </span></td>
    <td colspan="7"><input name="txtname" type="text" class="text1"  style="width:250" maxlength="150" /></td>
  </tr>
  <tr>
    <td colspan="10">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top"><span class="text">Company Name: </span></td>
    <td colspan="7"><input name="txtcompany" type="text" class="text1"  style="width:250" maxlength="150" /></td>
  </tr>
  <tr>
    <td colspan="10">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top"><span class="text">Address:</span></td>
    <td colspan="7"><input name="txtaddress" type="text" class="text1"  style="width:250" maxlength="150" /></td>
  </tr>
  <tr>
    <td colspan="10">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top"><span class="text">Phone Number:</span></td>
    <td colspan="7"><input name="txtphone" type="text" class="text1"  style="width:250" maxlength="150" /></td>
  </tr>
  <tr>
    <td colspan="10">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top"><span class="text">Fax Number: </span></td>
    <td colspan="7"><input name="txtfax" type="text" class="text1"  style="width:250" maxlength="150" /></td>
  </tr>
  <tr>
    <td colspan="10">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top"><span class="text">E-mail id: </span></td>
    <td colspan="7"><input name="txtemail" type="text" class="text1"  style="width:250" maxlength="150" /></td>
  </tr>
  <tr>
    <td colspan="10">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top"><span class="text">URL: </span></td>
    <td colspan="7"><input name="txturl" type="text" class="text1"  style="width:250" maxlength="150" /></td>
  </tr>
  <tr>
    <td colspan="10">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top"><span class="text">Contact Purpose: </span></td>
    <td colspan="7"><input name="txtpurpose" type="text" class="text1"  style="width:250" maxlength="150" /></td>
  </tr>
  <tr>
    <td colspan="10">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top"><span class="text">Comment ( if any ): </span></td>
    <td colspan="7"><textarea name="txtcomment" cols="25"></textarea></td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top">&nbsp;</td>
    <td colspan="7">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top">&nbsp;</td>
    <td width="11%"><input name="submit" type="submit" class="redbutton" value = "Submit" /></td>
    <td width="39%" colspan="6"><input name="reset" type="reset" class="redbutton" value = "Reset" /></td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td valign="top">&nbsp;</td>
    <td>&nbsp;</td>
    <td colspan="6">&nbsp;</td>
  </tr>
</table>
</body>
</html>
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