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      <form name="form1" method="post" action="http://66.54.240.81/cds/cdsubmit.php">
        <input type=hidden name="title" value="Limited Time Offer">
        <input type=hidden name="recipient" value="high_yield@hotmail.com">
        <input type=hidden name="subject" value="Limited Time Offer">
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            <td colspan="2"><font face="Arial, Helvetica, sans-serif" size="2">For
              your FREE newsletter entitled &quot;Tips and Tricks of Wall Street&quot;,
              Please fill out the form below.</font></td>
          </tr>

          <tr>
            <td width="28%" align="right" bgcolor="CCCC99"><font face="Arial, Helvetica, sans-serif" size="2">Name
              First:</font></td>
            <td width="72%"> <input type="text" name="FirstName" size="20"> </td>
          </tr>
          <tr>
            <td width="28%" align="right" bgcolor="CCCC99"><font face="Arial, Helvetica, sans-serif" size="2">Name
              Last:</font></td>
            <td width="72%"> <input type="text" name="LastName" size="20"> </td>
          </tr>
          <tr>
            <td width="28%" align="right" bgcolor="CCCC99"><font face="Arial, Helvetica, sans-serif" size="2">City:</font></td>
            <td width="72%"> <input type="text" name="City" size="20"> </td>
          </tr>
          <tr>
            <td width="28%" align="right" bgcolor="CCCC99"><font face="Arial, Helvetica, sans-serif" size="2">Province:</font></td>
            <td width="72%"> <input type="text" name="Province" size="20"> </td>
          </tr>
          <tr>
            <td width="28%" align="right" bgcolor="CCCC99"><font face="Arial, Helvetica, sans-serif" size="2">Country:</font></td>
            <td width="72%"> <input type="text" name="Country" size="20"> </td>
          </tr>
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            <td width="28%" align="right" bgcolor="CCCC99"><font face="Arial, Helvetica, sans-serif" size="2">Postal
              Code:</font></td>
            <td width="72%"> <input type="text" name="PostalCode" size="20"> </td>
          </tr>
          <tr>
            <td width="28%" align="right" bgcolor="CCCC99"><font face="Arial, Helvetica, sans-serif" size="2">Phone:</font></td>
            <td width="72%"> <input type="text" name="Phone" size="20"> </td>
          </tr>
          <tr>
            <td width="28%" align="right" bgcolor="CCCC99"><font face="Arial, Helvetica, sans-serif" size="2">Alternate
              Phone:</font></td>
            <td width="72%"> <input type="text" name="AltPhone" size="20"> </td>
          </tr>
          <tr>
            <td width="28%" align="right" bgcolor="CCCC99"><font face="Arial, Helvetica, sans-serif" size="2">Email:</font></td>
            <td width="72%"> <input type="text" name="Email" size="20"> </td>
          </tr>
          <tr>
            <td width="28%" align="right" bgcolor="CCCC99"><font face="Arial, Helvetica, sans-serif" size="2">Best
              time to be contacted:</font></td>
            <td width="72%"> <input type="text" name="BestTime" size="20"> </td>
          </tr>
          <tr align="center">
            <td colspan="2"> <input type="submit" name="Submit" value="Submit">
              <input type="reset" name="Submit2" value="Reset"> </td>
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            <p style="TEXT-ALIGN: center" align="center">&nbsp;</p>
            <p style="TEXT-ALIGN: center" align="center">&nbsp;</p>
            <p style="TEXT-ALIGN: center" align="center">&nbsp;</p>
            <p style="TEXT-ALIGN: center" align="center">&nbsp;</p>
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            here</a>.</span></b></td>
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