Haviland Corporation - Request Info

<body bgcolor="#1300A5" background="./pics/bg-blue.jpg" link="#1301A5" vlink="#A194FB"> <center> <table width=600 bgcolor="#FFFFFF" background="./pics/table-bg2.gif" border=0 cellpadding=0 cellspacing=0><tr><td> <font size=2 face="arial, helvetica"><img src="./pics/h-request.gif" width=144 height=144 alt="Request Info" align=right><img src="./pics/corner.gif" width=10 height=10 border=0><p><a href="./"><img src="./pics/sm-logo.gif" width=304 height=63 border=0 alt="Squeegee Manufacturers"></a><pre> </pre><img src="./pics/squeegee-menu.gif" align=left width=150 height=223 border=0 alt="Haviland Menu" usemap="#back" ismap><p> <pre> </pre><form METHOD="POST" action="_vti_bin/shtml.dll/request.htm" webbot-action="--WEBBOT-SELF--"> <input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><center><table border="0"> <tr> <td width="450"><font size=2 face="arial, helvetica"><strong>Check the products for which you want information:</strong> <ul> <pre> <input type="checkbox" name="FloorSqueegees" value="yes">Floor Squeegees <input type="checkbox" name="FloorMachine" value="yes">Floor Machine Replacement <input type="checkbox" name="WindowSqueegees" value="yes">Window Squeegees <input type="checkbox" name="PavingTools" value="yes">Paving Tools, ProPave <input type="checkbox" name="Waterbrooms" value="yes">Waterbrooms <input type="checkbox" name="Howtobecome" value="yes">How to become a Wholesaler </pre> </ul> </font></td> </tr> </table> </center> <pre> </pre> <br clear=all><center><table border="0" width="500"> <tr> <td width="100%"><font size=2 face="arial, helvetica"><strong>Add your comments:</strong> <dl> <pre> <textarea name="comments" rows="6" cols="50"> </textarea> </pre> </dl> </font></td> </tr> </table> </center> <center><table border="0" width="500"> <tr> <td width="100%"><font size=2 face="arial, helvetica"><strong>Information About You:</strong> </font></font><dl> <dd> <table> <tr><td><font size=2 face="Arial">Company Name:: </font></td> <font size=2 face="arial, helvetica"><td><font size=2 face="arial, helvetica"><input type="text" size="35" maxlength="256" name="CompanyName"></font></td></tr> </font> <tr><td><font size=2 face="Arial">Name: </font></td> <font size=2 face="arial, helvetica"><td><font size=2 face="arial, helvetica"><input type="text" size="35" maxlength="256" name="Name"></font></td></tr> </font> <tr><td><font size=2 face="Arial">Address1: </font></td> <font size=2 face="arial, helvetica"><td><font size=2 face="arial, helvetica"><input type="text" size="30" maxlength="256" name="StreetAddr1"></font></td></tr> </font> <tr><td><font size=2 face="Arial">Address2: </font></td> <font size=2 face="arial, helvetica"><td><font size=2 face="arial, helvetica"><input type="text" size="30" maxlength="256" name="StreetAddr2"></font></td></tr> </font> <tr><td><font size=2 face="Arial">City: </font></td> <font size=2 face="arial, helvetica"><td><font size=2 face="arial, helvetica"><input type="text" size="20" maxlength="256" name="City"></font></td></tr> </font> <tr><td><font size=2 face="Arial">State: </font></td> <font size=2 face="arial, helvetica"><td><font size=2 face="arial, helvetica"><input type="text" size="15" maxlength="256" name="State"></font></td></tr> </font> <tr><td><font size=2 face="Arial">Zip Code: </font></td> <font size=2 face="arial, helvetica"><td><font size=2 face="arial, helvetica"><input type="text" size="10" maxlength="10" name="ZipCode"></font></td></tr> </font> <tr><td><font size=2 face="Arial">Telephone: </font></td> <font size=2 face="arial, helvetica"><td><font size=2 face="arial, helvetica"><input type="text" size="20" maxlength="256" name="Phone"></font></td></tr> </font> <tr><td><font size=2 face="Arial">FAX: </font></td> <font size=2 face="arial, helvetica"><td><font size=2 face="arial, helvetica"><input type="text" size="20" maxlength="256" name="FAX"></font></td></tr> </font> <tr><td><font size=2 face="Arial">E-mail: </font></td> <font size=2 face="arial, helvetica"><td><font size=2 face="arial, helvetica"><input type="text" size="30" maxlength="256" name="Email"></font></td></tr></table> </dd> </dl> </td> </tr> </table> </center> <center><table border="0" width="500"> <tr> <td width="100%"><font size=2 face="arial, helvetica"><strong>How do you want this information sent?</strong> <dl> <pre><input type="checkbox" name="sendby" value="mail">Please send by regular mail <input type="checkbox" name="callme" value="yes">Please call me</pre> </dl> <p><br> </p> <pre> <input type="submit" value="submit now"> <input type="reset" value="clear form"></pre> </font></td> </tr> </table> </center> </form> <center> <p> <hr> <p><font size=2><b>800-325-3915</b><p> { <a href="coprofile.htm">Company Info</a> } { <a href="sales.htm">Sales Reps</a> } { <a href="request.htm">Request Info</a> }<br> { <a href="spotlight.htm">In The Spotlight</a> }<br> { <a href="floorsqueegees.htm">Floor Squeegees</a> } { <a href="windowsqueegees.htm">Window Squeegees</a> } { <a href="floormachine.htm">Floor Machine Replacement Parts</a> }<br> { <a href="propave.htm">Paving Tools</a> } { <a href="waterbrooms.htm">Waterbrooms</a> } { <a href="links.htm">Links</a> }<br> <b>{ <a href="./">Home</a> }</b> </font> <p> <font size=1 face="arial, helvetica"> <i>Copyright &#169 1999-2001 by Haviland Corporation - ALL RIGHTS RESERVED.</i></font><br> <font SIZE="1">Hosted by <a HREF="http://www.primelink.com/">PrimeLink</a><br> Design by <a HREF="http://www.4sightdesign.com/">4 Sight Design</a></font> <p> </center> <img src="./pics/corner-bl.gif" width=10 height=10 border=0></font></td></tr> </table></center> <map name="back"> <area shape="rect" coords="24,42 150,58" href="coprofile.htm" target="_top"> <area shape="rect" coords="24,59 150,71" href="sales.htm" target="_top"> <area shape="rect" coords="24,72 150,86" href="request.htm" target="_top"> <area shape="rect" coords="24,87 150,102" href="spotlight.htm" target="_top"> <area shape="rect" coords="24,103 150,118" href="floorsqueegees.htm" target="_top"> <area shape="rect" coords="24,119 150,132" href="windowsqueegees.htm" target="_top"> <area shape="rect" coords="24,133 150,147" href="floormachine.htm" target="_top"> <area shape="rect" coords="24,148 150,161" href="propave.htm" target="_top"> <area shape="rect" coords="24,162 150,177" href="waterbrooms.htm" target="_top"> <area shape="rect" coords="24,178 150,191" href="links.htm" target="_top"> </map> </body>