<?xml version="1.0" encoding="UTF-8"?>

<form url="default_form.php"
 window="_self"
 method="POST"
 fontname="MS Sans Serif"
 width="600"
 height="600"
 bkcolor="0xFFFFFF"
 transparent="f"
 fontcolor="0x000000"
 outlinecolor="0x000000"
 themecolor="0xFFFF99"
 fontcolor2="#000000"
 bkcolor2="#FFFFFF"
 includeresults="false"
 emailuser="true"
 verifymessage="The E-Mail address you entered does not match !"
 reqmessage="One or More Fields are Required"
 transition="0"
 autoresponseincluderesults="f"
 autoresponseaddtotop="f"
 usephp="true"
 disableclicktoactiveprompt="true"
 extensions="*.txt;*.gif;*.jpg;*.jpeg;*.zip;*.doc;*.png;*.pdf;*.rtf"
>

<hidden
 name="subject"
 value="Quote Request"
></hidden>

<image
 image="pencil-logo.jpg"
 x="431"
 y="468"
></image>

<textinput
 name="Name"
 x="8"
 y="92"
 w="175"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
 editable="true"
>
</textinput>

<textinput
 name="Email"
 x="8"
 y="140"
 w="175"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
 emailbox="true"
 editable="true"
  restrict="email"
>
</textinput>

<textinput
 name="Email verification"
 x="8"
 y="184"
 w="175"
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 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
 editable="true"
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>
</textinput>

<textinput
 name="Telephone"
 x="8"
 y="228"
 w="175"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<textinput
 name="Collection Address 1"
 x="8"
 y="280"
 w="175"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<textinput
 name="Collection Address 2"
 x="8"
 y="308"
 w="175"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<textinput
 name="Collection Address 3"
 x="8"
 y="332"
 w="175"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<textinput
 name="Collection Post Code"
 x="8"
 y="376"
 w="175"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<combobox
 name="Day Required"
 x="296"
 y="96"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 isemail="false"
 w="71"
 h="20">
  <item name="Day"></item>
  <item name="1"></item>
  <item name="2"></item>
  <item name="3"></item>
  <item name="4"></item>
  <item name="5"></item>
  <item name="6"></item>
  <item name="7"></item>
  <item name="8"></item>
  <item name="9"></item>
  <item name="10"></item>
  <item name="11"></item>
  <item name="12"></item>
  <item name="13"></item>
  <item name="14"></item>
  <item name="15"></item>
  <item name="16"></item>
  <item name="17"></item>
  <item name="18"></item>
  <item name="19"></item>
  <item name="20"></item>
  <item name="21"></item>
  <item name="22"></item>
  <item name="23"></item>
  <item name="24"></item>
  <item name="25"></item>
  <item name="26"></item>
  <item name="27"></item>
  <item name="28"></item>
  <item name="29"></item>
  <item name="30"></item>
  <item name="31"></item>
</combobox>

<combobox
 name="Month Required"
 x="372"
 y="96"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 isemail="false"
 w="90"
 h="20">
  <item name="Month"></item>
  <item name="01"></item>
  <item name="02"></item>
  <item name="03"></item>
  <item name="04"></item>
  <item name="05"></item>
  <item name="06"></item>
  <item name="07"></item>
  <item name="08"></item>
  <item name="09"></item>
  <item name="10"></item>
  <item name="11"></item>
  <item name="12"></item>
</combobox>

<combobox
 name="Year Required"
 x="464"
 y="96"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 isemail="false"
 w="100"
 h="20">
  <item name="Year"></item>
  <item name="2008"></item>
  <item name="2009"></item>
</combobox>

<combobox
 name="Collect Hours"
 x="296"
 y="148"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 isemail="false"
 w="64"
 h="20">
  <item name="Hour"></item>
  <item name="01"></item>
  <item name="02"></item>
  <item name="03"></item>
  <item name="04"></item>
  <item name="05"></item>
  <item name="06"></item>
  <item name="07"></item>
  <item name="08"></item>
  <item name="09"></item>
  <item name="10"></item>
  <item name="11"></item>
  <item name="12"></item>
  <item name="13"></item>
  <item name="14"></item>
  <item name="15"></item>
  <item name="16"></item>
  <item name="17"></item>
  <item name="18"></item>
  <item name="19"></item>
  <item name="20"></item>
  <item name="21"></item>
  <item name="22"></item>
  <item name="23"></item>
</combobox>

<combobox
 name="Collect Minutes"
 x="360"
 y="148"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 isemail="false"
 w="62"
 h="20">
  <item name="Minutes"></item>
  <item name="00"></item>
  <item name="05"></item>
  <item name="10"></item>
  <item name="15"></item>
  <item name="20"></item>
  <item name="25"></item>
  <item name="30"></item>
  <item name="35"></item>
  <item name="40"></item>
  <item name="45"></item>
  <item name="50"></item>
  <item name="55"></item>
</combobox>

<combobox
 name="Number of Passengers"
 x="296"
 y="196"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 isemail="false"
 w="100"
 h="20">
  <item name="1"></item>
  <item name="2"></item>
  <item name="3"></item>
  <item name="4"></item>
  <item name="5"></item>
  <item name="6"></item>
</combobox>

<combobox
 name="Luggage Ammount"
 x="432"
 y="196"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 isemail="false"
 w="100"
 h="20">
  <item name="1"></item>
  <item name="2"></item>
  <item name="3"></item>
  <item name="4"></item>
  <item name="5"></item>
  <item name="6"></item>
  <item name="7"></item>
  <item name="8"></item>
</combobox>

<combobox
 name="Destination Address Chossen"
 x="296"
 y="252"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 isemail="false"
 w="186"
 h="20">
  <item name="Choose 1 or fill in address below:"></item>
  <item name="Heathrow Terminal 1"></item>
  <item name="Heathrow Terminal 2"></item>
  <item name="Heathrow Terminal 3"></item>
  <item name="Heathrow Terminal 4"></item>
  <item name="Heathrow Terminal 5"></item>
  <item name="Gatwick North Terminal"></item>
  <item name="Gatwick South Terminal"></item>
  <item name="London Stansted"></item>
  <item name="Luton Airport"></item>
</combobox>

<textinput
 name="Destination Address 1"
 x="296"
 y="280"
 w="175"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<textinput
 name="Destination Address 2"
 x="296"
 y="308"
 w="175"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<textinput
 name="Destination Address 3"
 x="296"
 y="332"
 w="175"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<textinput
 name="Destination Post Code"
 x="296"
 y="376"
 w="175"
 h="22"
 initvalue=""
 maxchars="25"
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 editable="true"
>
</textinput>

<textarea
 name="Special Request"
 x="92"
 y="440"
 w="314"
 h="84"
 initvalue=""
 wordwrap="true"
 editable="true"
 bkcolor="0xFFFFFF"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></textarea>

<submitbutton
 name="Submit Button"
 x="156"
 y="532"
 w="185"
 h="20"
 label="Send Request"
 fontname="Georgia"
 fontcolor="0x000000"
  fontsize="12"
></submitbutton>

<label
 name="My Text 1"
 x="100"
 y="420"
 w="273"
 h="14"
 text="Special Requests/ Additional Information"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 2"
 x="4"
 y="168"
 w="130"
 h="14"
 text="Email Verification:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 3"
 x="4"
 y="124"
 w="139"
 h="14"
 text="Your E-Mail Address:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 4"
 x="40"
 y="44"
 w="89"
 h="14"
 text="Your Details:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 6"
 x="4"
 y="212"
 w="76"
 h="14"
 text="Telephone:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 5"
 x="8"
 y="76"
 w="46"
 h="14"
 text="Name:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 7"
 x="8"
 y="264"
 w="128"
 h="14"
 text="Collection Address:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 8"
 x="4"
 y="360"
 w="64"
 h="14"
 text="Post Code"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 9"
 x="380"
 y="44"
 w="116"
 h="14"
 text="Your Destination"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 10"
 x="296"
 y="76"
 w="100"
 h="14"
 text="Date Required:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 11"
 x="296"
 y="132"
 w="110"
 h="14"
 text="Collection Time:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 12"
 x="296"
 y="180"
 w="79"
 h="14"
 text="Passengers:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 13"
 x="444"
 y="180"
 w="61"
 h="14"
 text="Luggage:"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 14"
 x="296"
 y="236"
 w="136"
 h="14"
 text="Destination Address"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

<label
 name="My Text 15"
 x="296"
 y="360"
 w="64"
 h="14"
 text="Post Code"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x0000FF"
  fontsize="11"
></label>

</form>