Copy the raw HTML below to include the form on your web page:
<form action="http://gammoncity.com/v-cgi/forms.cgi"
      enctype="application/x-www-form-urlencoded"
      method="post">
<table>  <tr>
    <th align="right">
      Full Name:
    </th>
    <td>
      <input type="text" name="Full_Name"  size="30" />
    </td>
  </tr>
  <tr>
    <th align="right">
      Address:
    </th>
    <td>
      <input type="text" name="Address"  size="30" />
    </td>
  </tr>
  <tr>
    <th align="right">
      Address 2:
    </th>
    <td>
      <input type="text" name="Address_2"  size="30" />
    </td>
  </tr>
  <tr>
    <th align="right">
      City:
    </th>
    <td>
      <input type="text" name="City"  size="30" />
    </td>
  </tr>
  <tr>
    <th align="right">
      Postal Code:
    </th>
    <td>
      <input type="text" name="Postal_Code"  size="30" />
    </td>
  </tr>
  <tr>
    <th align="right">
      Country:
    </th>
    <td>
      <input type="text" name="Country"  size="30" />
    </td>
  </tr>
  <tr>
    <th align="right">
      Email Address:
    </th>
    <td>
      <input type="text" name="Email_Address"  size="30" />
    </td>
  </tr>
  <tr>
    <th align="right">
      phone number:
    </th>
    <td>
      <input type="text" name="phone_number"  size="30" />
    </td>
  </tr>
  <tr valign="top">
    <th align="right">
      Your Notes:
    </th>
    <td>
      <textarea name="Your_Notes" rows="6" cols="26"></textarea>
    </td>
  </tr>
  <tr>
    <th></th>
    <td>
     <input type="submit" name="Form_Submit" value="Submit Form" />
    </td>
  </tr>
</table><input type="hidden" name="_vDeckformid" value="234" />
</form>

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