<html>
<head>
<title>Guestbook Script</title>
</head>
<BODY BGCOLOR="#FFFFFF">
<P>
<FORM method="post" Action="/Academics/Faculty/jeburns/cgi-bin/gb_branch.cgi">
<INPUT NAME="name" Size=50 Type="text"> <B>Your Name</B><BR>
<INPUT NAME="email" Size=50 Type="text"> <B>Your E-Mail Address</B><BR>
<p>
<B>Would you like to sign up for our Newsletter?</B>
<INPUT TYPE="radio" NAME="newsletter" VALUE="yes"> <B>Yes</B>
<INPUT TYPE="radio" NAME="newsletter" VALUE="no"> <B>No</B><P>
<INPUT TYPE="hidden" NAME="submitaddress" VALUE="joe@i-55.com">
<B>Write to me below:</B><P>
<TEXTAREA NAME="feedback" ROWS=10 COLS=50></TEXTAREA><P>
<center>
<INPUT TYPE=submit Value="SEND">
<INPUT TYPE=reset Value="CLEAR">
</center>
</FORM>
</body>
</html>