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<div id="LayerE10" style="visibility: visible; overflow: auto; width:620px; height:390px; z-index:0; left:35px; top:26px; position:absolute; "> <form action="/EZ/p4s/p4s/page02.php?PHPSESSID=ertf2gv249bsvj2l3063vvkrn1" method="post" name="form1" onSubmit="MM_validateForm('firstname2','','R','lastname','','R','daytelephone','','R','eveningtelephone','','R','email','','RisEmail','housename','','R','area','','R','country','','R','dates','','R');return document.MM_returnValue"> <table width="600" border="0" bgcolor="#ffffff" align="center" cellpadding="2" cellspacing="0"> <tr> <td colspan="2" > </td> </tr> <tr> <td align="center" colspan="2" > <img src="images/pageheader.gif" border="0"> </td> </tr> <tr> <td align="center" colspan="2" > </td> </tr> <tr> <td align="center" colspan="2" > <div class="Blue_SubHead">Application to advertise with Properties4Spain</div> </tr> <tr> <td align="center" colspan="2" > <table width="100%" border="0" bgcolor="#ffffff" align="center" cellpadding="0" cellspacing="0"> <tr> <td width="55" > </td> <td> <div align="left" class="Black_Text"><br><br> Please fill in the form below to give us some preliminary details. <br><br> We will contact you by email to give you more information about advertising<br> and to answer any of your questions.</div> </td> </tr> </table> </td> </tr> <tr> <td align="center" colspan="2" > </td> </tr> <tr> <td align="right" nowrap class="style2"> <div align="right" class="Black_Text_Bold"><label>Title</label> </div> </td> <td align="left" width="375" height="33"><select id="title" name="Title"> <option selected>Mr</option> <option>Mrs</option> <option>Miss</option> <option>Ms</option> <option>Dr</option> </select></td> </tr> <tr> <td nowrap class="style2"> <div align="right" class="Black_Text_Bold"><label>First name</label> </div> </td> <td height="33"><input name="FirstName" type="text" id="firstname2" size="44" maxlength="44"> <span class="Black_Text_Bold"><span class="Red_Text_Bold">*</span> </span></td> </tr> <tr> <td nowrap class="style2"><div align="right" class="Black_Text_Bold"> <label> <span class="style2">Last name </span> </label> </div></td> <td height="33"> <input name="LastName" type="text" id="lastname" size="44" maxlength="44"> <span class="Black_Text_Bold"><span class="Red_Text_Bold">*</span> </span> </td> </tr> <tr> <td nowrap><div align="right" class="Black_Text_Bold"> <label><span class="style2">Day Telephone</span></label> </div></td> <td height="33"><input name="DayTelephone" type="text" id="daytelephone"> <span class="Black_Text_Bold"> <span class="Red_Text_Bold">*</span> </span></td> </tr> <tr> <td nowrap><div align="right" class="Black_Text_Bold"> <label><span class="style2">Evening Telephone</span></label> </div></td> <td height="33"><input name="EveningTelephone" type="text" id="eveningtelephone"> <span class="Black_Text_Bold"> <span class="Red_Text_Bold">*</span> </span></td> </tr> <tr> <td nowrap><div align="right" class="Black_Text_Bold"> <label><span class="style2">Email Address</span></label> </div></td> <td height="33"><input name="Email" type="text" id="email" onBlur="MM_validateForm('textfield3','','RisEmail');return document.MM_returnValue" size="44" maxlength="44"> <span class="Black_Text_Bold"> <span class="Red_Text_Bold">*</span> </span></td> </tr> <tr> <td nowrap><div align="right" class="Black_Text_Bold"> <label><span class="style2">Fax</span></label> </div></td> <td height="33"><input name="Fax" type="text" id="fax" ></td> </tr> <tr> <td nowrap><div align="right" class="Black_Text_Bold"> <label><span class="style2">House Name or Number </span></label> </div></td> <td height="33"><input name="House" type="text" id="housename" size="44" maxlength="44"> <span class="Black_Text_Bold"><span class="Red_Text_Bold">*</span> </span></td> </tr> <tr> <td valign="top" nowrap><div align="right" class="Black_Text_Bold"> <label><span class="style2">Address</span></label> </div></td> <td height="33"><textarea name="Address" cols="33" rows="6" id="address"></textarea></td> </tr> <tr> <td nowrap><div align="right" class="Black_Text_Bold"><span class="style2">Area code </span></div></td> <td height="33"><input name="AreaCode" type="text" id="area"> <span class="Black_Text_Bold"><span class="Red_Text_Bold">*</span> </span></td> </tr> <tr> <td nowrap><div align="right" class="Black_Text_Bold"> <label><span class="style2">Country</span></label> </div></td> <td height="33"><input name="Country" type="text" id="country" size="44" maxlength="44"> <span class="Black_Text_Bold"><span class="Red_Text_Bold">*</span> </span></td> </tr> <tr> <td nowrap><div align="right" class="Black_Text_Bold"> <label><span class="style2">Location of property</span></label> </div></td> <td height="33"><input name="Location" type="text" id="Location" size="44" maxlength="44"> <span class="Black_Text_Bold"><span class="Red_Text_Bold">*</span> </span></td> </tr> <tr> <td valign="top" nowrap ><div align="right" class="Black_Text_Bold"> <label><span class="style2">Notes</span></label> </div></td> <td height="33" valign="top"><textarea name="Notes" cols="33" rows="6" id="notes"></textarea></td> </tr> <tr> <td nowrap ><div align="right" class="Black_Text_Bold"> <label></label> </div></td> <td height="33" valign="top"><input type="submit" name="Submit" value="Submit"> <span class="Red_Text_Bold">*</span> <span class="Red_Text_Bold">Denotes required fields </span></td> </tr> <tr> <td align="center" colspan="2" > </td> </tr> </table> <input type="hidden" name="form_act" value="form1"> <input type="hidden" name="PHPSESSID" value="1hmkpj48qipl93hn2rjhoaro55"> </form></div>
