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<H1>PC Magazine HTML Form and Script Demo</H1>

<FORM method="POST" action="http://www.peds.csmc.edu/demo.pl">

<B>Contact Information:</B><BR>
<INPUT NAME="name" SIZE=50> Full Name<BR>
<INPUT NAME="company" SIZE=50> Company<BR>
<INPUT NAME="street" SIZE=50> Street Address<BR>
<INPUT NAME="city" SIZE=50> City, State, Zip Code<BR>
<INPUT NAME="email" SIZE=50> Email Address<BR>
<INPUT NAME="phone" SIZE=50> Phone Number<BR>
<INPUT NAME="fax" SIZE=50> FAX number<BR>

<P>
<B>Computer Experience</B><BR>
<SELECT NAME="experience">
<OPTION>Veteran Hacker
<OPTION>Novice Programmer
<OPTION>Power User
<OPTION>Newbie User
<OPTION>Other
</SELECT>
<P>

<input type="submit" value="Submit">
<input type="reset" value="Reset">

</FORM>

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<ADDRESS>
Created 6/17/96 / Last modified 6/17/96<BR>
PC Magazine Power Programming / <A HREF="mailto:duncan@csmc.edu">duncan@cerf.net</A>
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