<form action="/cgi-bin/fproc.cgi" method="post" name="[YOUR FORM'S NAME HERE]">
<input type="hidden" name="submit_to" value="[YOUR EMAIL ADDRESS HERE]" />
<input type="hidden" name="form_id" value="[YOUR EMAIL SUBJECT HERE]" />
<input type="hidden" name="required" value="field1, field2, submit_by" />
<input type="hidden" name="data_order" value="field1, field2, submit_by" />
<input type="hidden" name="outputfile"
value="/webusers/requests/ewhacct" />
<table width="400" border="0"
cellpadding="5" cellspacing="0">
<tr>
<td width="40%"><strong>Field 1:</strong></td>
<td><input type="text" name="field1" size="40" /></td>
</tr>
<tr>
<td width="40%"><strong>E-mail:</strong></td>
<td><input type="text" name="submit_by" size="40" /></td>
</tr>
<tr>
<td width="40%" valign="top"><strong>Field 2:</strong></td>
<td><textarea name="field2" cols="32" rows="4"></textarea></td>
</tr>
<tr>
<td width="40%" valign="top"></td>
<td><div align="right">
<input type="submit" name="Submit" value="Submit" />
</div></td>
</tr>
</table>
</form>