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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>

<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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