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<head>
<title>Link Request Contact Form - American Financing</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
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<body bgcolor="#8080C0">
<div align="center">
<table width="424" border="0">
<tr>
<td width="466"><form method="post" action="output.php" enctype="multipart/form-data">
<table width="424" border="0" cellpadding="3" cellspacing="0">
<tr bgcolor="#FFFFFF">
<td colspan="2"><img src="link-image.jpg" width="424" height="139"></td>
</tr>
<tr bgcolor="#FFFFFF">
<td width="224"> <div align="right"><font size="2" face="Arial, Helvetica, sans-serif">Full
Name:</font></div></td>
<td width="194"> <input name="Full_Name" type="text" id="Full_Name" size="26"></td>
</tr>
<tr bgcolor="#FFFFFF">
<td> <div align="right"><font size="2" face="Arial, Helvetica, sans-serif">E-mail
Address:</font></div></td>
<td> <input name="email" type="text" id="email" size="26"></td>
</tr>
<tr bgcolor="#FFFFFF">
<td> <div align="right"><font size="2" face="Arial, Helvetica, sans-serif">Where
is the link back to our site?</font></div></td>
<td> <input name="Link_Back" type="text" id="Link_Back" size="26"></td>
</tr>
<tr bgcolor="#FFFFFF">
<td> <div align="right"><font size="2" face="Arial, Helvetica, sans-serif">Your
Site's Title:</font></div></td>
<td> <input name="Site_Title" type="text" id="Site_Title" size="26"></td>
</tr>
<tr bgcolor="#FFFFFF">
<td> <div align="right"><font size="2" face="Arial, Helvetica, sans-serif">Your
Site's Web Address:</font></div></td>
<td> <input name="You_Web_Address" type="text" id="You_Web_Address" size="26"></td>
</tr>
<tr bgcolor="#FFFFFF">
<td> <div align="right"><font size="2" face="Arial, Helvetica, sans-serif">Please
Briefly Describe Your Site:</font></div></td>
<td> <textarea name="Site_Description" id="Site_Description"></textarea></td>
</tr>
<tr bgcolor="#FFFFFF">
<td colspan="2"> <div align="center"><font size="2" face="Arial, Helvetica, sans-serif"><br>
<strong><font color="#FF0000" size="1">Banner Upload</font></strong></font><font color="#FF0000" size="1"><strong><font face="Arial, Helvetica, sans-serif">
- JPG or GIF Only and under 2 megs</font></strong></font><br>
<input name="upload" type="file" size="20">
<br>
<br>
</div></td>
</tr>
<tr bgcolor="#FFFFFF">
<td colspan="2"> <div align="center">
<input type="submit" name="Submit" value="Submit">
<br>
<br>
</div></td>
</tr>
</table>
</form></td>
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<font size="1" face="Arial, Helvetica, sans-serif">Provided By: <a href="http://www.americanfinancing.net">American
Financing</a></font></div>
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