<HTML>
<HEAD>
<TITLE>PLACE THE TITLE OF YOUR FORM HERE</TITLE>
</HEAD>
<BODY>
<FORM ACTION = "http://www.neiu.edu/~LOGIN/form.cgi" METHOD = "POST">
<INPUT TYPE = "hidden" NAME = "mailto" VALUE = "YOUR EMAIL ADDRESS HERE">
<INPUT TYPE = "hidden" NAME = "html_response"
VALUE = "THE RESPONSE THE SUBMITTER SEES ON THE WEB GOES HERE.">
<INPUT TYPE = "hidden" NAME = "email_subject"
VALUE = "NAME OF THIS FORM GOES HERE">
<INPUT TYPE = "hidden" NAME = "variable_order"
VALUE = "PUT ALL THE NAMES OF EACH INPUT ITEM HERE SEPARATED BY |">
<INPUT TYPE = "hidden" NAME = "required_variables"
VALUE = "PUT THE NAMES OF REQUIRED INPUT ITEMS HERE SEPARATED BY |">
<INPUT TYPE = "hidden" NAME = "url_of_this_form"
VALUE = "PUT THE URL OF THIS FORM HERE">
<INPUT TYPE = "hidden" NAME = "response_title" VALUE = "Thank You">
<INPUT TYPE = "hidden" NAME = "return_link_name"
VALUE = "PUT THE NAME OF THE PAGE THEY'LL RETURN TO HERE">
<INPUT TYPE = "hidden" NAME = "return_link_url"
VALUE = "PUT THE url OF THE PAGE THEY'LL RETURN TO HERE">
<INPUT TYPE = "hidden" NAME = "database_name" VALUE =
"PUT THE FILENAME AND LOCATION OF THE DATABASE FILE">
<INPUT TYPE = "hidden" NAME = "database_delimiter" VALUE = ",">
<H2>FORM NAME COULD GO HERE</H2>
<BR> <B>NAME OF FIRST INPUT ITEM AS SEEN BY USER</B>
<INPUT TYPE = "text" NAME = "NAME OF INPUT ITEM 1" SIZE = "35" MAXLENGTH = "35">
<B>NAME OF SECOND INPUT ITEM AS SEEN BY USER</B>
<INPUT TYPE = "text" NAME = "NAME OF INPUT ITEM 2" SIZE = "35" MAXLENGTH
= "35">
<BR> <B>NAME OF THIRD INPUT ITEM AS SEEN BY USER</B>
<BR> SOMETHING LIKE A QUESTION COULD GO HERE:
<OL>
<LI>CHOICE 1<INPUT TYPE = "radio" NAME = "NAME OF INPUT ITEM3" VALUE="CHOICE
1">
<LI>CHOICE 2<INPUT TYPE = "radio" NAME = "NAME OF INPUT ITEM3" VALUE="CHOICE
2">
<LI>CHOICE 3<INPUT TYPE= "radio" NAME = "NAME OF INPUT ITEM3" VALUE="CHOICE
3">
</OL>
<B>NAME OF FOURTH INPUT ITEM AS SEEN BY USER</B>
<BR> SOMETHING LIKE A QUESTION COULD GO HERE:
<OL>
<LI>CHOICE 1<INPUT TYPE = "radio" NAME = "NAME OF INPUT ITEM4" VALUE="CHOICE
1">
<LI>CHOICE 2<INPUT TYPE = "radio" NAME = "NAME OF INPUT ITEM4" VALUE="CHOICE
2">
<LI>CHOICE 3<INPUT TYPE= "radio" NAME = "NAME OF INPUT ITEM4" VALUE="CHOICE
3">
</OL>
<CENTER>
<INPUT TYPE = "submit" VALUE = "PUT SUBMIT FORM OR SIMILAR HERE">
</CENTER>
</FORM>
</BODY>
</HTML>