Powerski Questionnaire

<body > <table border="0" cellpadding="0" cellspacing="0" width="705"> <tr> <td><img src="images/header.jpg" width="750" height="105"></td> </tr> </table> <table border="0" cellpadding="0" cellspacing="0" width="100%"> <tr> <td> <table border="0" cellpadding="0" cellspacing="0" width="96%"> <tr> <td valign="top" width="180"> <table border="0" cellpadding="0" cellspacing="0" width="175"> <tr> <td><img src="images/navtop.gif" width="161" height="34"></td> </tr> <tr> <td><a href="home.html"><img name="home" src="images/home.gif" width="161" height="28" border="0"></a></td> </tr> <tr> <td><a href="engineering.html"><img name="engineering" border="0" src="images/engineering.gif" width="161" height="30"></a></td> </tr> <tr> <td><a href="dealers.html"><img name="dealers" border="0" src="images/dealers.gif" width="161" height="27"></a></td> </tr> <tr> <td><a href="distributors.html"><img name="distributors" border="0" src= "images/distributors.gif" width="161" height="30"></a></td> </tr> <tr> <td><a href="sponsors.html"><img name="sponsors" border="0" src="images/sponsors.gif" width="161" height="29"></a></td> </tr> <tr> <td><a href="calender.html"><img name="calendar" border="0" src="images/calendar.gif" width="161" height="29"></a></td> </tr> <tr> <td><a href="pastevents.html"><img name="pastevents" border="0" src="images/pastevents.gif" width="161" height="32"></a></td> </tr> <tr> <td><a href="media.html"><img name="media" border="0" src="images/media.gif" width="161" height="30"></a></td> </tr> <tr> <td><a href="questionnaire.html"><img name="questionare" border="0" src="images/questionare.gif" width="161" height="32"></a></td> </tr> <tr> <td><a href="team.html"><img name="team" border="0" src="images/team.gif" width="161" height="33"></a></td> </tr> <tr> <td><a href="aboutpsi.htm"><img name="aboutpsi" border="0" src="images/aboutpsi.gif" width="161" height="32"></a></td> </tr> <tr> <td><a href="press.html"><img name="press" border="0" src="images/press.gif" width="161" height="34"></a></td> </tr> <tr> <td><img src="images/navbottom.gif" width="161" height="142"></td> </tr> </table> <a href="http://www.nmma.org/" target="_blank" title="NMMA"><img src="images/logo_nmma_member.gif" width="154" height="31" border="0" align="top"><br> <img src="http://service.bfast.com/bfast/serve?bfmid=37920209&siteid=39225274&bfpage=logo" border="0" width="1" height="1" nosave></a><a title="PTC" href="http://www.ptc.com/partners/racing/" target="_blank"><img src="images/ptc_logo.gif" width="179" height="59" border="0"></a><a href="http://www5.compaq.com/products/customer_stories/powerski.html" title="HP Invent" target="_blank"><br> <img src="images/hp_logo.gif" width="66" height="55" border="0"></a><a href="http://www5.compaq.com/products/customer_stories/powerski.html" title="HP Invent" target="_blank"><br> </a><a href="http://www.capture3d.com" target="_blank"><img src="images/capute3dlogo.gif" alt="Capture 3D" height="51" width="112" border="0"></a><br> <a href="http://www.avid.com" target="_blank"><img src="images/avid_logo.gif" alt="Avid" height="36" width="80" border="0"></a></td> <td align="left" valign="top"> <table border="0" cellpadding="0" cellspacing="0" width="90%"> <tr> <td width="65%"> <table width="100%" border="0" cellspacing="2" cellpadding="0"> <tr> <td width="40"></td> <td><span class="headline">POWERSKI QUESTIONNAIRE</span></td> </tr> </table> </td> </tr> <tr> <td width="65%"> <table border="0" cellpadding="0" cellspacing="0" width="473"> <tr> <td valign="top"> <FORM name="qform" METHOD="POST" ACTION="/cgi-bin/gen-form?webmaster@powerski.com+success-url=thanks.html+User+Feedback" onSubmit="return validate()"> Please fill out all fields below...thank you. <table border="0" cellpadding="2" cellspacing="2" frame width="508" height="600"> <tr> <td width="42%">What is your interest?<br> (Please pick one)</td> <td> <center> <select name="Interest" size="1"> <option value="Consumer">Consumer</option> <option value="Dealer">Dealer</option> <option value="Distributor">Distributor</option> <option value="Investor">Investor</option> </select></center> </td> </tr> <tr> <td width="42%">Where did you hear of the Jetboard? <span class="smalltxt">(be specific)</span></td> <td><input type="TEXT" name="Where" size="42"></td> </tr> <tr> <td width="42%">Name</td> <td><input type="TEXT" name="Name" size="42"></td> </tr> <tr height="22"> <td width="42%" height="22">Age</td> <td height="22"><input type="TEXT" name="Age" size="42"></td> </tr> <tr> <td width="42%">Profession</td> <td><input type="TEXT" name="Profession" size="42"></td> </tr> <tr> <td width="42%">Company Name</td> <td><input type="TEXT" name="Company" size="42"></td> </tr> <tr> <td width="42%">Approx. Income</td> <td><input type="TEXT" name="Income" size="42"></td> </tr> <tr> <td width="42%">Street Address</td> <td><input type="TEXT" name="Address" size="42"></td> </tr> <tr> <td width="42%">City</td> <td><input type="TEXT" name="City" size="42"></td> </tr> <tr> <td width="42%">State/Providence</td> <td><input type="TEXT" name="State" size="42"></td> </tr> <tr> <td width="42%">Zip/Postal Code</td> <td><input type="TEXT" name="Zip" size="42"></td> </tr> <tr> <td width="42%">Country</td> <td><input type="TEXT" name="Country" size="42"></td> </tr> <tr> <td width="42%">Phone Number</td> <td><input type="TEXT" name="Phone" size="42"></td> </tr> <tr> <td width="42%">Email Address</td> <td><input type="TEXT" name="email" size="42"></td> </tr> <tr> <td width="42%">What action sports do you do?</td> <td><textarea name="What.action.sports.do.you.do" cols="40" rows="4"></textarea></td> </tr> <tr> <td width="42%">Do you own a watercraft?<br> If so what kind?</td> <td><input type="TEXT" name="Watercraft" size="42"></td> </tr> <tr> <td width="42%">Would you buy a Powerski?</td> <td><input type="TEXT" name="Buy" size="42"></td> </tr> <tr> <td width="42%">Why?</td> <td><input type="TEXT" name="Why" size="42"></td> </tr> </table> <P>Additional comments please:<br> <textarea name="comments" cols="36" rows="4"></textarea> <P><INPUT TYPE="submit" VALUE="Send Info"> <INPUT TYPE="reset" VALUE="Reset Form"> </FORM> </td> </tr> </table> </td> </tr> </table> </td> </tr> </table> </td> </tr> <tr> <td> <table border="0" cellpadding="0" cellspacing="0" width="756"> <tr> <td width="25%"></td> <td> <div align="center"> <A href="home.html">home</A> | <A href="engineering.html">engineering</A> | <A href="dealers.html">dealers</A> | <A href="distributors.html">distributors</A> | <A href="calender.html">calendar</A> | <A href="pastevents.html">past events<br> </A><A href="media.html">media </A> | <A href="questionnaire.html">questionnaire</A> | <A href="team.html">the team</A> | <A href="aboutpsi.htm">about psi</A> | <A href="press.html">press releases</A><br> <br> 150-A Calle Iglesia, San Clemente, CA 92672<br> PH: 949-369-3920 FX: 949-492-1621<br> <a href="mailto:info@powerski.com">info@powerski.com</a></div> </td> </tr> </table> </td> </tr> </table> </BODY>