Name:
<!-- Begin Response-O-Matic Form -->
<!-- DO NOT EDIT YOUR FORM HERE, PLEASE LOG IN AND EDIT AT RESPONSE-O-MATIC.COM -->
<form enctype="multipart/form-data" method="post" action="http://www.response-o-matic.com/mail.php" accept-charset="UTF-8">
<div>
<input type="hidden" name="acctid" id="acctid" value="6idzlp9nwjhyreo5" />
<input type="hidden" name="formid" id="formid" value="905397" />
<input type="hidden" name="required_vars" id="required_vars" value="name,email,field-172eda9bab8b434" />
</div>
<table cellspacing="5" cellpadding="5" border="0">
<tr>
<td valign="top">
<strong>Name:</strong>
</td>
<td valign="top">
<input type="text" name="name" id="name" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Email Address:</strong>
</td>
<td valign="top">
<input type="text" name="email" id="email" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Message</strong>
</td>
<td valign="top">
<textarea name="field-172eda9bab8b434" id="field-172eda9bab8b434" rows="6" cols="40"></textarea>
</td>
</tr>
<tr>
<td colspan="2" align="center">
<input type="submit" value=" Submit Form " />
</td>
</tr>
</table>
</form>
<br><center><font face="Arial, Helvetica" size="1"><b>
This <a href="http://www.response-o-matic.com">contact form</a> was created by Freedback.
</b></font></center>
<!-- End Response-O-Matic Form -->
NAME
tEMAIL ADDRESS
tMESSAGE
Double click to editEmail - ali@purebengals.co.uk Tel - 01405 818017
