Note: If you will be using the form on the USNA intranet web site, change the line that reads

      <form method="post" action="http://www.usna.edu/cgi-bin/yform">

to

      <form method="post" action="http://intranet.usna.edu/cgi-bin/yform">

<html>
<head>
<title>USNA Webmasters FAQ - Sample Form</title>
<meta name="USNA" content="John Paul Jones, USNA Webmaster
Information Technology Services Division
e-mail: webmaster@usna.edu
Revised : 04 Jul 1776">
</head>

<body>

<table border="0" width="600">
<tr>
<td>
<center>
<font size="3"><b>Professional Interest Questionnaire</b></font>
</center><span class="bodytext"> </span>
<p>

<p>
<br>
Please fill out the form:<br>
<br>
</p>

<form method="post" action="http://www.usna.edu/cgi-bin/yform">

<input type="hidden" name="recipient" value="webmaster@usna.edu">
<input type="hidden" name="subject" value="Professional Information Questionnaire from Webmaster's Page">

<pre>
        Your name      : <input size="34" maxlength="48" name="name">
        E-mail address : <input size="34" maxlength="40" name="email_address">
        Phone          : <input size="12" maxlength="12" name="phone">


        I would like information about the following topics:
        <input type="checkbox" name="Surface" value="I am interested"> Surface Warfare
        <input type="checkbox" name="Aviation" value="I am interested"> Aviation
        <input type="checkbox" name="Special Forces" value="I am interested"> Special Forces

</pre>
<center>

<input type="submit" value="Send Survey">
or
<input type="reset" value="Clear Survey">
</center>
</form>

</td>
</tr>
</table>

</body>
</html>