Onze Button: <br>

<br>
<img src=http://img168.imageshack.us/img168/3848/thumb67e65ud0.jpg><img src=http://i27.tinypic.com/25zmav8.jpg>

<br>

Gelieve ook onze Button op jouw site te plaatsen !<br>




<form method="post" enctype="multipart/form-data" action="http://pub47.bravenet.com/emailfwd/senddata.php">
<input type="hidden" name="usernum" value="4002874974">
<input type="hidden" name="cpv" value="2">
<!-- DO NOT CHANGE OR REMOVE THE 3 TAGS ABOVE THIS COMMENT-->

<table border="0" cellpadding="0" cellspacing="0" align="center">
<tr>
<td><h3 style="border-bottom:1px solid black;">Affiliates</h3></td>
</tr>
<tr>
<td>

<label for="name" style="float:left;width:140px;">Name</label><input type="text" name="name" id="name" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label for="Email" style="float:left;width:140px;">E-Mail Address:</label><input type="text" name="Email" id="Email" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label for="site" style="float:left;width:140px;">Site Url</label><input type="text" name="site" id="site" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label for="button" style="float:left;width:140px;">Button Url</label><input type="text" name="button" id="button" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label for="else" style="float:left;width:140px;">Anything Else?</label><textarea name="else" id="else" style="width:200px;height:150px;"></textarea><div style="clear:left;height:20px;"> </div>


</td>
<tr>
<td align="right">
<!-- YOU CAN MODIFY THE TEXT WITHIN VALUE="" TO MODIFY YOUR BUTTON TEXT-->
<input type="submit" value=" Submit "> <input type="reset" value=" Reset ">
</td>
</tr>
</table>
</form>