Content-Type: text/html

<html>
<head><title>REXXWEB</title></head>
<body bgcolor="#FFFFFF">
<h1>REXXWEB - URL Form</h1>
#message#
<p>
<form method=post action="#httpcgiserver#urlform.cmd">
<table width=600 cellpadding=0 cellspacing=0 border=0>
<tr><td>Integer:</td><td><input type="TEXT" name="integer" value="#integer#" size=50></td></tr>
<tr><td>Dollar:</td><td><input type="TEXT" name="dollar" value="#dollar#" size=50></td></tr>
<tr><td>E-mail:</td><td><input type="TEXT" name="email" value="#email#" size=50></td></tr>
<tr><td valign=top>Comment:</td><td><textarea name="comment" valign=bottom rows=5 cols=50>#comment#</textarea></td></tr>
<tr><td>&nbsp;</td><td><input type="checkbox" name="active" #active# value="1"> Yes Please send me more information.</td></tr>
<tr><td colspan=2>&nbsp;</td></tr>
<tr><td>&nbsp;</td><td><input type="SUBMIT" value="Go"></td></tr>
</table>
</form>

</body>
</html>
