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Current File : /domains/roemmelt1/feedback.htm
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<meta name="GENERATOR" content="Microsoft FrontPage 5.0">
<title>Feedback Form</title>

</head>

<body background="images/Gray_Textured.gif">

<p><!--webbot bot="PurpleText" preview="Customize the form below to collect the information you need. By default, the form data is saved to a text file on the web server using the WebBot Save Results component. Edit the Form Properties to change this behavior." --> </p>

<h1>Information Request/Feedback Form</h1>

<hr align="center">

<p>Tell us what you think about our web site, our products, our organization, or anything
else that comes to mind. We welcome all of your comments and suggestions.</p>

<form method="POST" action="_vti_bin/shtml.dll/feedback.htm" webbot-action="--WEBBOT-SELF--">
  <!--webbot bot="SaveResults" s-email-format="TEXT/PRE" s-email-address="[email protected]" startspan --><input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><!--webbot bot="SaveResults" endspan i-checksum="43374" --><p><strong>What kind of comment would you like to send?</strong><dl>
    <dd>
    <input type="radio" name="MessageType" value="More Information on a training product1" checked>More Information on a Training Product</dd>
    <dd><input type="radio" name="MessageType" value="EQ assess and coaching2">Emotional 
    Intelligence assessment and coaching</dd>
    <dd><input type="radio" name="MessageType" value="Problem">Problem identified on our web
      site</dd>
    <dd><input type="radio" name="MessageType" value="Suggestion">Suggestion</dd>
    <dd><input type="radio" name="MessageType" value="Praise">Praise&nbsp; </dd>
  </dl>
  <p><strong>Enter your comments in the space provided below:</strong><dl>
    <dd><textarea name="Comments" rows="5" cols="42"></textarea></dd>
  </dl>
  <p><strong>Tell us how to get in touch with you:</strong><dl>
    <dd><pre>Name     <input type="text" size="35" maxlength="256" name="UserName">
E-mail   <input type="text" size="35" maxlength="256" name="UserEmail">
Tel      <input type="text" size="35" maxlength="256" name="UserTel">
FAX      <input type="text" size="35" maxlength="256" name="UserFAX">     </pre>
    </dd>
  </dl>
  <dl>
    <dd><input type="checkbox" name="ContactRequested" value="ContactRequested"> Please contact
      me as soon as possible regarding this matter.</dd>
  </dl>
  <p><input type="submit" value="Submit Comments"> <input type="reset" value="Clear Form"></p>
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<hr align="center">

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<area href="products.htm" shape="rect" coords="215, 12, 362, 109">
<area href="people.htm" shape="rect" coords="79, 12, 207, 110">
<area href="Default-old.htm" shape="rect" coords="0, 14, 73, 110">
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<img rectangle="(79,12) (207,110) people.htm" rectangle="(0,14) (73,110) Default.htm" src="images/menu_bar_with_graphics.gif" alt="menu bar with graphics.gif (11642 bytes)" border="0" usemap="#FPMap0" width="485" height="111"></p>

<h5 align="center"><br>
Copyright � 1998 <em><strong>21t century leadership</strong></em>&nbsp; All rights
reserved.<br>
Revised: <!--webbot bot="TimeStamp" s-type="EDITED" s-format="%B %d, %Y" startspan -->October 07, 2005<!--webbot bot="TimeStamp" endspan i-checksum="30603" -->.</h5>
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Anon7 - 2021