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<form url="predform.php"
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 verifymessage="The E-Mail address you entered does not match !"
 reqmessage="One or More Fields are Required !"
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 usephp="true"
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 extensions="*.txt;*.gif;*.jpg;*.jpeg;*.zip;*.doc;*.png;*.pdf;*.rtf"
>

<hidden
 name="thankyoupage"
 value="http://www.suddenserviceonline.com/pepsisb/sbcoupon.html"
></hidden>

<hidden
 name="subject"
 value="Predators Tickets"
></hidden>

<image
 image="ssonlineweb.png"
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 y="1"
></image>

<image
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></image>

<textinput
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>
</textinput>

<textinput
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>
</textinput>

<textinput
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>
</textinput>

<textinput
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>
</textinput>

<textinput
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>
</textinput>

<textinput
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>
</textinput>

<textinput
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>
</textinput>

<textinput
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>
</textinput>

<textinput
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>
</textinput>

<checkbox
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<textinput
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>
</textinput>

<checkbox
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></checkbox>

<submitbutton
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 fontbold="bold"
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></submitbutton>

<label
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 y="336"
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  fontcolor="0x000000"
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></label>

<label
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></label>

<label
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></label>

<label
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></label>

<label
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 y="432"
 w="103"
 h="16"
 text="Phone Number:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
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 y="456"
 w="114"
 h="16"
 text="Phone Number 2:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
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></label>

<label
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 y="480"
 w="33"
 h="16"
 text="Age:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
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></label>

<label
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 y="504"
 w="98"
 h="16"
 text="Email Address:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 16"
 x="56"
 y="212"
 w="596"
 h="29"
 text="Sudden Service - Nashville Predators Prize Package"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="23"
></label>

<label
 name="My Text 17"
 x="36"
 y="252"
 w="616"
 h="22"
 text="Your chance to win 2 Tickets and a Prize Package from Budweiser"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="19"
></label>

<label
 name="My Text 18"
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 y="612"
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 text="Limited to one entry per person per IP address, per email per day"
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></label>

<label
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 h="16"
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  fontcolor="0x000000"
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></label>

<label
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 y="556"
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 h="16"
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 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
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 y="572"
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></label>

<label
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  fontsize="13"
></label>

<label
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></label>

<label
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></label>

</form>