<div>

<h1>Password Reminder</h1>

<form action="" method="post">
	<table align="center" border="0" cellspacing="0" cellpadding="3">
		<tr><td>Username:</td><td><INPUT type="text" name="user" maxlength="30"></td></tr>
		<tr><td></td></tr>
		<tr><td>Email:</td><td><INPUT type="password" name="email" maxlength="30"></td></tr>
		<tr><td colspan="2" align="right"><br><INPUT type="submit" name="subpass" value="Send Password"></td></tr>
		<tr><td>&nbsp;</td></tr>
	</table>
</form>

</div>