LCW Sales


		<table width="346" cellpadding="5" cellspacing="0" border="0"> <tr> <td width="346" bgcolor="#000000"> <h1>LCW SALES</h1> <p align="justify"><b>To complete a sales enquiry please fill out the form below.</b></p> <p>A LCW sales representative will contact you shortly.</p> <table width="100%" cellpadding="8" cellspacing="0" border="0"> <form action="http://www.hirelimos.com/cgi-bin/lcwenquiry.cgi" method="POST"> <tr> <td style="border: 1px 1px 1px 1px solid white;"> <p><b>Your full name</b></b><br><input type="text" name="Name"></p> <p><b>Company</b><br><input type="text" name="Company"></p> <p><b>Your email</b><br><input type="text" name="Email"></p> <p><b>Telephone</b><br><input type="text" name="Telephone"></p> <p><b>Fax</b><br><input type="text" name="Fax"></p> <p><b>Address</b><br><input type="text" name="Addr1"><br><input type="text" name="Addr2"><br><input type="text" name="Addr3"><br><input type="text" name="Addr4"></p> <hr color="#FFFFFF"> <p><b>Which vehicle(s) are you interested in?</b><br><br><input type="checkbox" name="Vehicles" value="Lincoln Town Car Blue Crush">Lincoln Town Car Blue Crush<br><input type="checkbox" name="Vehicles" value="Ford Excursion Red Dragon">Ford Excursion Red Dragon<br><input type="checkbox" name="Vehicles" value="Chrysler C300 Ultimate & Raider">Chrysler C300 Ultimate & Raider<br><input type="checkbox" name="Vehicles" value="Lincoln Navigator Red Dragon">Lincoln Navigator Red Dragon<br><input type="checkbox" name="Vehicles" value="Cadillac Escalade">Cadillac Escalade<br><input type="checkbox" name="Vehicles" value="Lincoln Town Car Rio">Lincoln Town Car Rio</p> <hr color="#FFFFFF"> <p><b>Do you want delivery...</b><br><br><input type="radio" name="Delivery" value="Immediately">Immediately<br><input type="radio" name="Delivery" value="Next 2 weeks">Next 2 Weeks<br><input type="radio" name="Delivery" value="30 days">30 days<br><input type="radio" name="Delivery" value="60 days">60 days<br><input type="radio" name="Delivery" value="90 days">90 days<br><input type="radio" name="Delivery" value="Sometime after 90 days">Sometime after 90 days<br></p> <hr color="#FFFFFF"> <p><b>Additional information</b><br><textarea cols="30" rows="6" wrap="virtual"></textarea></p> <hr color="#FFFFFF"> <div align="center"><input type="submit" value="Send Enquiry" name="Enquiry"></div> </td> </tr> </form> </table><br> </td> </tr> </table>