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<form action="http://www.myfreelancermods.com/cgi-bin/contact/contact.cgi" method="post">
<center>
    <table width="100%" border=0 cellpadding=4 cellspacing=0>
      <tr>
        <td> <center>
            <big><b>Contacting My Freelancer Mods</b></big> 
            <p> If you have a question, <a href="/faq.shtml">check the FAQ</a> 
              for an answer before you contact us.
            <p> 
            
            <p> <b>Submit Message to My Freelancer Mods Support Staff</b> <br>
              
              <br>
            <input type="hidden" name="do" value="freelancers">
            <div align="center">
              <center>
                <table border="0">
                  <tr> 
                    <td width="40%" align="right">Your Username: </td>
                    <td width="60%"><input type="text" name="user" size="20"> 
                      </td>
                  </tr>
                  <tr> 
                    <td width="40%" align="right">Your Password: </td>
                    <td width="60%"><input type="password" name="pass" size="20"> 
                     </td>
                  </tr>
                  <tr> 
                    <td width="40%" align="right">Category: </td>
                    <td width="60%"><select name="category" class="tbox">
                        <option value="General">General</option>
						<option value="Certified">Become a Certified Member</option>
                        <option value="Billing">Billing</option>
                        <option value="Project Cancellations">Project Cancellations</option>
                        <option value="Suspended Accounts">Suspended Accounts</option>
                        <option value="Problems & Disputes">Problems & Disputes</option>
                        <option value="Abuse">Abuse</option>
                      </select></td>
                  </tr>
                  <tr> 
                    <td width="40%" align="right">Priority: </td>
                    <td width="60%"><select name="priority" class="tbox">
                        <option value="1">Urgent</option>
                        <option value="2">High</option>
                        <option value="3">Normal</option>
                        <option value="4" selected>Low</option>
                        <option value="5">Very Low</option>
                      </select></td>
                  </tr>
                  <tr> 
                    <td width="40%" align="right">Subject: </td>
                    <td width="60%"><input type="text" name="subject" size="40"></td>
                  </tr>
                  <tr> 
                    <td width="100%" colspan="2"> <center>
                        <table>
                          <tr>
                            <td>Your Message:<br> <textarea rows="10" name="message" cols="50"></textarea> 
                            </td>
                          </tr>
                        </table>
                        <p> 
                          <input name="submit" type="submit" value="Submit Message">
                        </center></td>
                  </tr>
                </table>
              </center>
            </div>
          </center></td>
      </tr>
    </table>
    <br>
  </center>
	  
</form>

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