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<h1>Contacts</h1>


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</tr>


<tr>
<td style="width:135px">Your Name <select name="salutation" id="select">
<option value="Mr.">Mr.</option>
<option value="Mrs.">Mrs.</option>
<option value="Ms.">Ms.</option>
<option value="n/a" selected> </option>
</select> <input name="fname" type="text" size="50" maxlength="30"></td>
</tr>

<tr>
<td style="vertical-align:top">Contact e-mail <input name="email" type="text" size="50">

</td>
</tr>

<td style="vertical-align:top">Country <select name="country">


<option value="" selected>Please choose ...</option><optgroup label="">
<option value="AU">Australia</option>
<option value="AT">Austria</option>
<option value="CA">Canada</option>
<option value="DK">Denmark</option>
<option value="FR">France</option>
<option value="DE">Germany</option>
<option value="NL">Netherlands</option>
<option value="CH">Switzerland</option>
<option value="GB">United Kingdom</option>
<option value="US">United States</option>
</optgroup>
<optgroup label="---- All countries ----">

<option value="AL">Albania</option><option value="DZ">Algeria</option><option value="AS">American Samoa</option><option value="AD">Andorra</option><option value="AO">Angola</option><option value="AI">Anguilla</option><option value="AQ">Antarctica</option><option value="AG">Antigua and Barbuda</option><option value="AR">Argentina</option><option value="AW">Aruba</option><option value="AU">Australia</option><option value="AT">Austria</option><option value="BS">Bahamas</option><option value="BH">Bahrain</option><option value="BD">Bangladesh</option><option value="BB">Barbados</option><option value="BE">Belgium</option><option value="BZ">Belize</option><option value="BJ">Benin</option><option value="BM">Bermuda</option><option value="BT">Bhutan</option><option value="BO">Bolivia</option><option value="BA">Bosnia and Herzegowina</option><option value="BW">Botswana</option><option value="BV">Bouvet Island</option><option value="BR">Brazil</option><option value="IO">British Indian Ocean Territory</option><option value="BN">Brunei Darussalam</option><option value="BG">Bulgaria</option><option value="BF">Burkina Faso</option><option value="BI">Burundi</option><option value="KH">Cambodia</option><option value="CM">Cameroon</option><option value="CA">Canada</option><option value="CV">Cape Verde</option><option value="KY">Cayman Islands</option><option value="TD">Chad</option><option value="CL">Chile</option><option value="CX">Christmas Island</option><option value="CC">Cocos (Keeling) Islands</option><option value="CO">Colombia</option><option value="KM">Comoros</option><option value="CG">Congo</option><option value="CD">Congo, Democratic Republic of</option><option value="CK">Cook Islands</option><option value="CR">Costa Rica</option><option value="CI">Cote D'ivoire</option><option value="HR">Croatia (Hrvatska)</option><option value="CY">Cyprus</option><option value="CZ">Czech Republic</option><option value="DK">Denmark</option><option value="DJ">Djibouti</option><option value="DM">Dominica</option><option value="DO">Dominican Republic</option><option value="TP">East Timor</option><option value="EC">Ecuador</option><option value="EG">Egypt</option><option value="SV">El Salvador</option><option value="GQ">Equatorial Guinea</option><option value="ER">Eritrea</option><option value="EE">Estonia</option><option value="ET">Ethiopia</option><option value="FK">Falkland Islands</option><option value="FO">Faroe Islands</option><option value="FJ">Fiji</option><option value="FI">Finland</option><option value="FR">France</option><option value="GF">French Guiana</option><option value="PF">French Polynesia</option><option value="TF">French Southern Territories</option><option value="GA">Gabon</option><option value="GM">Gambia</option><option value="GE">Georgia</option><option value="DE">Germany</option><option value="GH">Ghana</option><option value="GI">Gibraltar</option><option value="GR">Greece</option><option value="GL">Greenland</option><option value="GD">Grenada</option><option value="GP">Guadeloupe</option><option value="GU">Guam</option><option value="GT">Guatemala</option><option value="GG">Guernsey</option><option value="GN">Guinea</option><option value="GW">Guinea-bissau</option><option value="GY">Guyana</option><option value="HT">Haiti</option><option value="HM">Heard and McDonald Islands</option><option value="HN">Honduras</option><option value="HK">Hong Kong</option><option value="HU">Hungary</option><option value="IS">Iceland</option><option value="ID">Indonesia</option><option value="IE">Ireland</option><option value="IM">Isle of Man</option><option value="IL">Israel</option><option value="IT">Italy</option><option value="JM">Jamaica</option><option value="JP">Japan</option><option value="JE">Jersey</option><option value="JO">Jordan</option><option value="KE">Kenya</option><option value="KI">Kiribati</option><option value="KP">Korea, Democratic People's Republic of</option><option value="KW">Kuwait</option><option value="LA">Lao People's Democratic Republic</option><option value="LV">Latvia</option><option value="LB">Lebanon</option><option value="LS">Lesotho</option><option value="LR">Liberia</option><option value="LY">Libya</option><option value="LI">Liechtenstein</option><option value="LT">Lithuania</option><option value="LU">Luxembourg</option><option value="MO">Macau</option><option value="MK">Macedonia</option><option value="MG">Madagascar</option><option value="MW">Malawi</option><option value="MY">Malaysia</option><option value="MV">Maldives</option><option value="ML">Mali</option><option value="MT">Malta</option><option value="MH">Marshall Islands</option><option value="MQ">Martinique</option><option value="MR">Mauritania</option><option value="MU">Mauritius</option><option value="YT">Mayotte</option><option value="MX">Mexico</option><option value="FM">Micronesia, Federated States of</option><option value="MC">Monaco</option><option value="MN">Mongolia</option><option value="MS">Montserrat</option><option value="MA">Morocco</option><option value="MZ">Mozambique</option><option value="MM">Myanmar</option><option value="NA">Namibia</option><option value="NR">Nauru</option><option value="NP">Nepal</option><option value="NL">Netherlands</option><option value="AN">Netherlands Antilles</option><option value="NC">New Caledonia</option><option value="NZ">New Zealand</option><option value="NI">Nicaragua</option><option value="NE">Niger</option><option value="NG">Nigeria</option><option value="NU">Niue</option><option value="NF">Norfolk Island</option><option value="MP">Northern Mariana Islands</option><option value="NO">Norway</option><option value="OM">Oman</option><option value="PK">Pakistan</option><option value="PW">Palau</option><option value="PA">Panama</option><option value="PG">Papua New Guinea</option><option value="PY">Paraguay</option><option value="PE">Peru</option><option value="PH">Philippines</option><option value="PN">Pitcairn</option><option value="PL">Poland</option><option value="PT">Portugal</option><option value="PR">Puerto Rico</option><option value="QA">Qatar</option><option value="RE">Reunion</option><option value="RO">Romania</option><option value="RW">Rwanda</option><option value="KN">Saint Kitts and Nevis</option><option value="LC">Saint Lucia</option><option value="VC">Saint Vincent and the Grenadines</option><option value="WS">Samoa</option><option value="SM">San Marino</option><option value="ST">Sao Tome and Principe</option><option value="SA">Saudi Arabia</option><option value="SN">Senegal</option><option value="RS">Serbia</option><option value="SC">Seychelles</option><option value="SL">Sierra Leone</option><option value="SG">Singapore</option><option value="SK">Slovakia (Slovak Republic)</option><option value="SI">Slovenia</option><option value="SB">Solomon Islands</option><option value="SO">Somalia</option><option value="ZA">South Africa</option><option value="GS">South Georgia and South Sandwich Islands</option><option value="ES">Spain</option><option value="LK">Sri Lanka</option><option value="SH">St. Helena</option><option value="PM">St. Pierre and Miquelon</option><option value="SR">Suriname</option><option value="SJ">Svalbard and Jan Mayen Islands</option><option value="SZ">Swaziland</option><option value="SE">Sweden</option><option value="CH">Switzerland</option><option value="TW">Taiwan, Republic of China</option><option value="TZ">Tanzania, United Republic of</option><option value="TH">Thailand</option><option value="TL">Timor-Leste</option><option value="TG">Togo</option><option value="TK">Tokelau</option><option value="TO">Tonga</option><option value="TT">Trinidad and Tobago</option><option value="TN">Tunisia</option><option value="TR">Turkey</option><option value="TC">Turks and Caicos Islands</option><option value="TV">Tuvalu</option><option value="UG">Uganda</option><option value="UA">Ukraine</option><option value="AE">United Arab Emirates</option><option value="GB">United Kingdom</option><option value="US">United States</option><option value="UY">Uruguay</option><option value="UM">US Minor Outlying Islands</option><option value="VU">Vanuatu</option><option value="VA">Vatican City State</option><option value="VE">Venezuela</option><option value="VN">Viet Nam</option><option value="VG">Virgin Islands (British)</option><option value="VI">Virgin Islands (U.S.)</option><option value="WF">Wallis and Futuna Islands</option><option value="EH">Western Sahara</option><option value="YE">Yemen</option><option value="ZM">Zambia</option></optgroup></select>

</td>
</tr>

<tr>
<th>Message</th>
</tr>

<tr>
<td><textarea name="messageA" cols="75" rows="9" id="messageA" style="font-family:Arial, Helvetica, sans-serif; font-size:13px"></textarea></td>
</tr>

<tr>
<th>Confirmation code</th>
</tr>
<tr><td><SCRIPT TYPE="text/javascript">
document.write('<img src="https://www2.visualtarot.com/vercode1.gif"><br><input name="ccodeS" type="text" size="70" maxlength="3" id="ccodeS" placeholder="Enter the three-digit verification code from the picture above">')</SCRIPT><noscript><span style="color:red;font-weight:bold">JavaScript required to submit this form.</span></noscript>
</td>
</tr>
</table>

<br>

<div style="padding-top:7px;padding-bottom:7px">
<button type="submit" style="font-size:150%;width:235px;height:57px"> SUBMIT </button>
</div>

</form> 
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