 <!-- /  -->
 <div class="base2">
 <div class="heading2">
 <div class="binner">
 <h1> 
 <br></h1>
 </div>
 </div>
 <div class="maincont"><div class="binner"><table class="tableform">
 <tbody><tr class="fieldtr">
 <td align="left"> :</td>
 <td><input maxlength="35" name="f4" class="f_input" type="text"></td>
 </tr>
 <tr class="fieldtr">
 <td align="left">E-Mail:</td>
 <td><input maxlength="35" name="f1" class="f_input" type="text"></td>
 </tr>
 <tr class="fieldtr">
 <td align="left">ICQ :</td>
 <td><input maxlength="45" name="f1" class="f_input" type="text"></td>
 </tr>
 
 <tr class="fieldtr">
 <td align="left">:</td>
 <td><textarea name="f3" style="width: 320px; height: 160px;" class="f_textarea"></textarea></td>
 </tr>
 <tr class="fieldtr">
 <td align="left"> :</td>
 <td><br>$SECURITY_CODE$</td>
 </tr>
 <tr class="fieldtr">
 <td align="left"> :</td>
 <td><input maxlength="45" name="f7" style="width: 115px;" class="f_input" type="text"></td>
 </tr>
 <tr class="fieldtr">
 <td align="left">&nbsp;</td>
 <td><input ilo-full-src="/images/spacer.gif" name="sfSbm" class="okbtn" onmouseover="this.className='okbtnhover'" onmouseout="this.className='okbtn'" alt="" title="" src="/images/spacer.gif" type="image">
 </td>
 </tr>
 </tbody></table></div></div></div>
 <!-- /  -->