Application for User Account
From BSODWiki
<form name="Application" method="email" target="apply@bsodwiki.com" email="Your Email" sender="web@domain.com" submit="Send Inquiry" reset="Reset">
hidden: name="applyform" value="additional info" text:* name="email2" prompt="Confirm Your Email" text:* name="name" prompt="Your Name" textarea: name="description" prompt="Breifly describe your computer experience" rows="30" cols="80" select: name="jobtitle" prompt="Primary Job Function" option="Support Desk" option="Computer Tech" option="Member of I.T." option="Other" select: name="experience" prompt="Years in IT or Support" option="Less then 5 years" option="5 to 10 years" option="More then 10 years"
</form>