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<title>Modification Form </title>
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<table border="0" width="80%">
    <tr>
        <td align="center"><table border="0" width="100%">
            <tr>
                <td bgcolor="#0000FF">
		<a href="%%display%%">
		<font color="#FFFFFF"
                size="2" face="Arial"><strong>
		Modification of %%login%% </strong></font></a></td>
            </tr>
            <tr>
                <td valign="top" bgcolor="#F7F9D2">
	 <table border="0">
	    <tr><td>
		<p><br>
		<font color="#000080" size="2" face="Arial">
                <blockquote>
		Please modify the form below:
	    </td></tr>
                    <tr>
                        <td>
		<font color="#000080" size="2" face="Arial">
                <blockquote>

	<form action=pm.cgi method=get>
	<input type="hidden" name="action" value="modified">
	<input type="hidden" name="login" value="%%login%%">
	<input type="hidden" name="password" value="%%password%%">
	<table border="0">
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Login Name:
	</font></td>
        <td>%%login%%</td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Name:
	</font></td>
        <td><input type="text" size="15" name="name" value="%%name%%"></td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	E-mail:
	</font></td>
        <td><input type="text" size="15" name="email" value="%%email%%"></td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Address:</font></td>
        <td><textarea name="address" rows="3" cols="30"
        wrap="soft">%%address%%</textarea> </td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Country:
	</font></td>
        <td>

<select name="country">
<option value="%%country%%" selected>%%country%%
<option value="United States">United States <option value="Canada">Canada <option value="Afghanistan">Afghanistan <option value="Albania">Albania <option value="Algeria">Algeria <option value="American Samoa">American Samoa <option value="Andorra">Andorra <option value="Angola">Angola <option value="Anguilla">Anguilla <option value="Antarctica">Antarctica <option value="Antigua and Barbuda">Antigua and Barbuda <option value="Argentina">Argentina <option value="Armenia">Armenia <option value="Aruba">Aruba <option value="Australia">Australia <option value="Austria">Austria <option value="Azerbaidjan">Azerbaidjan <option value="Bahamas">Bahamas <option value="Bahrain">Bahrain <option value="Bangladesh">Bangladesh <option value="Barbados">Barbados <option value="Belarus">Belarus <option value="Belgium">Belgium <option value="Belize">Belize <option value="Benin">Benin <option value="Bermuda">Bermuda <option value="Bhutan">Bhutan <option value="Bolivia">Bolivia <option value="Bosnia-Herzegovina">Bosnia-Herzegovina <option value="Botswana">Botswana <option value="Bouvet Island">Bouvet Island <option value="Brazil">Brazil <option value="British Indian Ocean Territory">British Indian Ocean Territory <option value="Brunei Darussalam">Brunei Darussalam <option value="Bulgaria">Bulgaria <option value="Burkina Faso">Burkina Faso <option value="Burundi">Burundi <option value="Cambodia">Cambodia <option value="Cameroon">Cameroon <option value="Canada">Canada <option value="Cape Verde">Cape Verde <option value="Cayman Islands">Cayman Islands <option value="Central African Republic">Central African Republic <option value="Chad">Chad <option value="Chile">Chile <option value="China">China <option value="Christmas Island">Christmas Island <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands <option value="Colombia">Colombia <option value="Comoros">Comoros <option value="Congo">Congo <option value="Cook Islands">Cook Islands <option value="Costa Rica">Costa Rica <option value="Croatia">Croatia <option value="Cuba">Cuba <option value="Cyprus">Cyprus <option value="Czech Republic">Czech Republic <option value="Denmark">Denmark <option value="Djibouti">Djibouti <option value="Dominica">Dominica <option value="Dominican Republic">Dominican Republic <option value="East Timor">East Timor <option value="Ecuador">Ecuador <option value="Egypt">Egypt <option value="El Salvador">El Salvador <option value="Equatorial Guinea">Equatorial Guinea <option value="Eritrea">Eritrea <option value="Estonia">Estonia <option value="Ethiopia">Ethiopia <option value="Falkland Islands">Falkland Islands <option value="Faroe Islands">Faroe Islands <option value="Fiji">Fiji <option value="Finland">Finland <option value="Former Czechoslovakia">Former Czechoslovakia <option value="Former USSR">Former USSR <option value="France">France <option value="France (European Territory)">France (European Territory) <option value="French Guyana">French Guyana <option value="French Southern Territories">French Southern Territories <option value="Gabon">Gabon <option value="Gambia">Gambia <option value="Georgia">Georgia <option value="Germany">Germany <option value="Ghana">Ghana <option value="Gibraltar ">Gibraltar  <option value="Greece">Greece <option value="Greenland">Greenland <option value="Grenada">Grenada <option value="Guadeloupe (French)">Guadeloupe (French) <option value="Guam (USA)">Guam (USA) <option value="Guatemala">Guatemala <option value="Guinea">Guinea <option value="Guinea Bissau">Guinea Bissau <option value="Guyana">Guyana <option value="Haiti">Haiti <option value="Heard and McDonald Islands">Heard and McDonald Islands <option value="Honduras">Honduras <option value="Hong Kong">Hong Kong <option value="Hungary">Hungary <option value="Iceland">Iceland <option value="India">India <option value="Indonesia">Indonesia <option value="Iran">Iran <option value="Iraq">Iraq <option value="Ireland">Ireland <option value="Israel">Israel <option value="Italy">Italy <option value="Ivory Coast (Cote D'Ivoire)">Ivory Coast (Cote D'Ivoire) <option value="Jamaica">Jamaica <option value="Japan">Japan <option value="Jordan">Jordan <option value="Kazakhstan">Kazakhstan <option value="Kenya">Kenya <option value="Kiribati">Kiribati <option value="Kuwait">Kuwait <option value="Kyrgyzstan">Kyrgyzstan <option value="Laos">Laos <option value="Latvia">Latvia <option value="Lebanon">Lebanon <option value="Lesotho">Lesotho <option value="Liberia">Liberia <option value="Libya">Libya <option value="Liechtenstein">Liechtenstein <option value="Lithuania">Lithuania <option value="Luxembourg">Luxembourg <option value="Macau">Macau <option value="Macedonia">Macedonia <option value="Madagascar">Madagascar <option value="Malawi">Malawi <option value="Malaysia">Malaysia <option value="Maldives">Maldives <option value="Mali">Mali <option value="Malta">Malta <option value="Marshall Islands">Marshall Islands <option value="Martinique (French)">Martinique (French) <option value="Mauritania">Mauritania <option value="Mauritius">Mauritius <option value="Mayotte">Mayotte <option value="Mexico">Mexico <option value="Micronesia">Micronesia <option value="Moldova">Moldova <option value="Monaco">Monaco <option value="Mongolia">Mongolia <option value="Montserrat">Montserrat <option value="Morocco">Morocco <option value="Mozambique">Mozambique <option value="Myanmar">Myanmar <option value="Namibia">Namibia <option value="Nauru">Nauru <option value="Nepal">Nepal <option value="Netherlands">Netherlands <option value="Netherlands Antilles">Netherlands Antilles <option value="Neutral Zone">Neutral Zone <option value="New Caledonia (French)">New Caledonia (French) <option value="New Zealand">New Zealand <option value="Nicaragua">Nicaragua <option value="Niger">Niger <option value="Nigeria">Nigeria <option value="Niue">Niue <option value="Norfolk Island">Norfolk Island <option value="North Korea">North Korea <option value="Northern Mariana Islands">Northern Mariana Islands <option value="Norway">Norway <option value="Oman">Oman <option value="Pakistan">Pakistan <option value="Palau">Palau <option value="Panama">Panama <option value="Papua New Guinea">Papua New Guinea <option value="Paraguay">Paraguay <option value="Peru">Peru <option value="Philippines">Philippines <option value="Pitcairn Island">Pitcairn Island <option value="Poland">Poland <option value="Polynesia (French)">Polynesia (French) <option value="Portugal">Portugal <option value="Puerto Rico">Puerto Rico <option value="Qatar">Qatar <option value="Reunion (French)">Reunion (French) <option value="Romania">Romania <option value="Russian Federation">Russian Federation <option value="Rwanda">Rwanda <option value="S. Georgia & S. Sandwich Isls.">S. Georgia & S. Sandwich Isls. <option value="Saint Helena">Saint Helena <option value="Saint Kitts & Nevis Anguilla">Saint Kitts & Nevis Anguilla <option value="Saint Lucia">Saint Lucia <option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon <option value="Saint Vincent & Grenadines">Saint Vincent & Grenadines <option value="Samoa">Samoa <option value="Sao Tome and Principe">Sao Tome and Principe <option value="San Marino">San Marino <option value="Saudi Arabia">Saudi Arabia <option value="Senegal">Senegal <option value="Seychelles">Seychelles <option value="Sierra Leone">Sierra Leone <option value="Singapore">Singapore <option value="Slovak Republic">Slovak Republic <option value="Slovenia">Slovenia <option value="Solomon Islands">Solomon Islands <option value="Somalia">Somalia <option value="South Africa">South Africa <option value="South Korea">South Korea <option value="Spain">Spain <option value="Sri Lanka">Sri Lanka <option value="Sudan">Sudan <option value="Suriname">Suriname <option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands <option value="Swaziland">Swaziland <option value="Sweden">Sweden <option value="Switzerland">Switzerland <option value="Syria">Syria <option value="Tadjikistan">Tadjikistan <option value="Taiwan">Taiwan <option value="Tanzania">Tanzania <option value="Thailand">Thailand <option value="Togo">Togo <option value="Tokelau">Tokelau <option value="Tonga">Tonga <option value="Trinidad and Tobago">Trinidad and Tobago <option value="Tunisia">Tunisia <option value="Turkey">Turkey <option value="Turkmenistan">Turkmenistan <option value="Turks and Caicos Islands">Turks and Caicos Islands <option value="Tuvalu">Tuvalu <option value="Uganda">Uganda <option value="Ukraine">Ukraine <option value="United Arab Emirates">United Arab Emirates <option value="United Kingdom">United Kingdom <option value="United States">United States <option value="Uruguay">Uruguay <option value="Uzbekistan">Uzbekistan <option value="Vanuatu">Vanuatu <option value="Vatican City State">Vatican City State <option value="Venezuela">Venezuela <option value="Vietnam">Vietnam <option value="Virgin Islands (British)">Virgin Islands (British) <option value="Virgin Islands (USA)">Virgin Islands (USA) <option value="Wallis and Futuna Islands">Wallis and Futuna Islands <option value="Western Sahara">Western Sahara <option value="Yemen">Yemen <option value="Yugoslavia">Yugoslavia <option value="Zaire">Zaire <option value="Zambia">Zambia <option value="Zimbabwe ">Zimbabwe  
</select>
	</td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	State:
	</font></td>
        <td>

<select name="state">
<option value="%%state%%" selected>%%state%%
<option value=" Alabama "> Alabama  <option value=" Alaska "> Alaska  <option value="Alberta">Alberta <option value="Arizona">Arizona <option value="Arkansas">Arkansas <option value="British Columbia">British Columbia <option value="California">California <option value="Colorado">Colorado <option value="Connecticut">Connecticut <option value="D.C.">D.C. <option value="Delaware">Delaware <option value="Florida">Florida <option value="Georgia">Georgia <option value="Hawaii">Hawaii <option value="Idaho">Idaho <option value="Illinois">Illinois <option value="Indiana">Indiana <option value="Iowa">Iowa <option value="Kansas">Kansas <option value="Kentucky">Kentucky <option value="Louisiana">Louisiana <option value="Maine">Maine <option value="Manitoba">Manitoba <option value="Maryland">Maryland <option value="Massachusetts">Massachusetts <option value="Michigan">Michigan <option value="Minnesota">Minnesota <option value="Mississippi">Mississippi <option value="Missouri">Missouri <option value="Montana">Montana <option value="Nebraska">Nebraska <option value="Nevada">Nevada <option value="New Brunswick">New Brunswick <option value="New Hampshire">New Hampshire <option value="New Jersey">New Jersey <option value="New Mexico">New Mexico <option value="New York">New York <option value="Newfoundland">Newfoundland <option value="North Carolina">North Carolina <option value="North Dakota">North Dakota <option value="Northwest Terr.">Northwest Terr. <option value="Nova Scotia">Nova Scotia <option value="Ohio">Ohio <option value="Oklahoma">Oklahoma <option value="Ontario">Ontario <option value="Oregon">Oregon <option value="Pennsylvania">Pennsylvania <option value="Prince Edward Isl.">Prince Edward Isl. <option value="Quebec">Quebec <option value="Rhode Island">Rhode Island <option value="Saskatchewan">Saskatchewan <option value="South Carolina">South Carolina <option value="South Dakota">South Dakota <option value="Tennessee">Tennessee <option value="Texas">Texas <option value="Utah">Utah <option value="Vermont">Vermont <option value="Virginia">Virginia <option value="Washington">Washington <option value="West Virginia">West Virginia <option value="Wisconsin">Wisconsin <option value="Wyoming ">Wyoming  <option value="Yukon">Yukon
</select>

	</td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Phone:
	</font></td>
        <td><input type="text" size="15" name="tel" value="%%tel%%"></td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Age:
	</font></td>
        <td><input type="text" size="2" name="age" value="%%age%%"></td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>Sex:</td>
        <td><select name="sex" size="1">
            <option selected value="%%sex%%"> %%sex%% </option>
            <option value="male"> Male </option>
            <option value="female"> Female </option>
        </select></td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>Marital Status:</td>
        <td><select name="status" size="1">
            <option selected value="%%status%%"> %%status%% </option>
            <option value="single"> Single </option>
            <option value="married"> Married </option>
        </select></td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Occupation:
	</font></td>
        <td><input type="text" size="15" value="%%occupation%%" name="occupation"></td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Favorite Quote:</font></td>
        <td><textarea name="quote" rows="3" cols="30"
        wrap="soft">%%quote%%</textarea>&nbsp; </td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Hobbies:</font></td>
        <td><textarea name="hobbies" rows="3" cols="30"
        wrap="soft">%%hobbies%%</textarea>&nbsp; </td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	News:</font></td>
        <td><textarea name="news" rows="3" cols="30"
        wrap="soft">%%news%%</textarea>&nbsp; </td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Homepage:
	</font></td>
        <td><input type="text" size="15" name="homepage" value="%%homepage%%"></td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Company:
	</font></td>
        <td><input type="text" size="15" name="company" value="%%company%%"></td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Company web site:
	</font></td>
        <td><input type="text" size="15" name="company_url" value="%%company_url%%"></td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
	Notes:</font></td>
        <td><textarea name="notes" rows="3" cols="30"
        wrap="soft">%%notes%%</textarea>&nbsp; </td>
    </tr>
    <tr>
        <td><font color="#FF0000" face=Arial size=2>
<INPUT type="submit" name="submit" value="Modify"> 
</form></td>    </tr>
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                </blockquote>
                </td>
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            <tr>
                <td bgcolor="#0000FF"><a href=http://www.interlogy.com/scripts/pm/>
		<font color="#FFFFFF"
                size="2" face="Verdana"><strong>Interlogy
                Internet Technologies</a>, 1999-2001.</strong></font></td>
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