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<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">

<title>www.supergus.com, Email us!!!</title>

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<blockquote>

  <h1 align="center">Supergus Handyman Service</h1>

</blockquote>

<p>&nbsp;</p>

 

 

<form method=post action="https://gus321.tripod.com/forms?login=gus321">

<font face="arial, helvetica">

<b>Your name:</b><br>

<input type="text" name="Name" size="27">

<p>

 

<b>Your email address:</b><br>

<input type="text" name="URL" size="27">

<p>

 

<b>Your phone number:</b><br>

<input type="text" name="URL" size="27">

<p>

 

<b>What best describes the work needed ?</b><br>

<input type="radio" name="Visit" value="Interior">Interior<br>

<input type="radio" name="Visit" value="Exterior">Exterior<br>

<input type="radio" name="Visit" value="Painting">Painting<br>

<input type="radio" name="Visit" value="Flooring">Flooring<br>

<input type="radio" name="Visit" value="Bathroom">Bathroom<br>

<input type="radio" name="Visit" value="Kitchen">Kitchen<br>

<input type="radio" name="Visit" value="plumbing">Plumbing<br>

<input type="radio" name="Visit" value="electrical">Electrical<br>

<input type="radio" name="Visit" value="Lawn, gardening & landscape">Lawn, gardening & landscape<br>

<input type="radio" name="Visit" value="Honey Do List">Honey Do lists<br>

<input type="radio" name="Visit" value="Other">Other<br>

<p>

 

<b>Please describe what type of projects below:</b>

</font><br>

<textarea cols="40" rows="10" name="Comments"></textarea>

 

<p><br>

<input type="submit" value="Send">

<input type="reset" value="Clear the form">

 

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<input type="hidden" name="subject" value="Survey Results">

 

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<input type="hidden" name="required_fields" value="Name,URL">

 

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<input type="hidden" name="next_url" value="http://www.geocities.com/gus321/index.html">

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</form>

<p></p>

<center>

<a href="http://www.supergus.com">Back to Supergus.com</a>

 

<h2>GUS@SUPERGUS.COM</h2>

<a href="http://www.supergus.com"Back to Supergus.com</a>

<h3 align="center">copyright 2007, SUPERGUS HANDYMAN SERVICES</h3></center>

</body>

</html>


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