<!-- Begin Response-O-Matic Form -->
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<form enctype="multipart/form-data" method="post" action="http://www.response-o-matic.com/mail.php" accept-charset="UTF-8">
<div>
<input type="hidden" name="acctid" id="acctid" value="t70hivbrr5la5mla" />
<input type="hidden" name="formid" id="formid" value="358283" />
<input type="hidden" name="required_vars" id="required_vars" value="field-fe8767db7cb5e7c,name,email,field-48c41efe0f29a6c,field-749f6f6609a19e4,field-6980031e54cb03c,field-0830931c8be9f96" />
</div>
<table cellspacing="5" cellpadding="5" border="0">
<tr>
<td valign="top">
<strong>What Job Will You Want To Choose</strong>
</td>
<td valign="top">
<select name="field-fe8767db7cb5e7c" id="field-fe8767db7cb5e7c">
<option value="Co Administrators">Co Administrators</option>
<option value=""></option>
<option value="Global Moderators">Global Moderators</option>
<option value=""></option>
<option value="Commumnity Stuff">Commumnity Stuff</option>
<option value=""></option>
<option value="Forum Technical Team">Forum Technical Team</option>
<option value=""></option>
<option value="Forum Webmasters">Forum Webmasters</option>
</select>
</td>
</tr>
<tr>
<td valign="top">
<strong>Name:</strong>
</td>
<td valign="top">
<input type="text" name="name" id="name" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Email Address:</strong>
</td>
<td valign="top">
<input type="text" name="email" id="email" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Why Are You Good At This Job???</strong>
</td>
<td valign="top">
<input type="text" name="field-48c41efe0f29a6c" id="field-48c41efe0f29a6c" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Give Us One Reason Why We Choose You But Not Others???</strong>
</td>
<td valign="top">
<textarea name="field-749f6f6609a19e4" id="field-749f6f6609a19e4" rows="6" cols="40"></textarea>
</td>
</tr>
<tr>
<td valign="top">
<strong>How Many Hours You Offer A Days???</strong>
</td>
<td valign="top">
<input type="radio" name="field-6980031e54cb03c" id="field-6980031e54cb03c_0" value="1 hrs" /> 1 hrs<br/>
<input type="radio" name="field-6980031e54cb03c" id="field-6980031e54cb03c_1" value="" /> <br/>
<input type="radio" name="field-6980031e54cb03c" id="field-6980031e54cb03c_2" value="2 hrs" /> 2 hrs<br/>
<input type="radio" name="field-6980031e54cb03c" id="field-6980031e54cb03c_3" value="" /> <br/>
<input type="radio" name="field-6980031e54cb03c" id="field-6980031e54cb03c_4" value="3 hrs" /> 3 hrs<br/>
<input type="radio" name="field-6980031e54cb03c" id="field-6980031e54cb03c_5" value="" /> <br/>
<input type="radio" name="field-6980031e54cb03c" id="field-6980031e54cb03c_6" value="4 hrs" /> 4 hrs<br/>
<input type="radio" name="field-6980031e54cb03c" id="field-6980031e54cb03c_7" value="" /> <br/>
<input type="radio" name="field-6980031e54cb03c" id="field-6980031e54cb03c_8" value="almost all the time" /> almost all the time<br/>
</td>
</tr>
<tr>
<td valign="top">
<strong>If We Choose You Will You Willing To Help The Forum Members Reply To Them???</strong>
</td>
<td valign="top">
<input type="checkbox" name="field-0830931c8be9f96[]" id="field-0830931c8be9f96_0" value="Yes I Will" /> Yes I Will<br/>
<input type="checkbox" name="field-0830931c8be9f96[]" id="field-0830931c8be9f96_1" value="" /> <br/>
<input type="checkbox" name="field-0830931c8be9f96[]" id="field-0830931c8be9f96_2" value="No I Will Not" /> No I Will Not<br/>
</td>
</tr>
<tr>
<td colspan="2" align="center">
<input type="submit" value=" Submit Form " />
</td>
</tr>
</table>
</form>
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