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	<table width="880" border="0" align="center" cellpadding="5" cellspacing="0">
      <tr align="left" valign="top">
        <td><p><img src="images/hdr-parts-request.jpg" width="411" height="44"></p>
          <p>To request a specific machine part you are looking for, please fill out the form below. We will then follow up with you shortly. <span class="bodyText">(*</span> required) </p>
          <form action="formemail.php" method="post" onSubmit="MM_validateForm('Name','','R','Email','','RisEmail');return document.MM_returnValue">
<table width="500" border="0" align="center" cellpadding="4" cellspacing="0" id="Contact_Us" summary="This table will be turned into a form to send an e-mail to TMT">
        <caption align="bottom">
        <br />
        <input name="Submit" type="submit" onclick="MM_validateForm('email','','RisEmail');return document.MM_returnValue" value="Submit" />
        <input name="Reset" type="reset" id="Reset" value="Clear form" />
        </caption>
        <tr class="header">
          <td class="header"><div align="left" class="bodyText">Name*</div></td>
          <td width="250"><input name="realname" type="text" id="realname" size="42" maxlength="50" /></td>
        </tr>
        <tr class="header">
          <td class="header"><div align="left" class="bodyText">Company*</div></td>
          <td><input name="company" type="text" id="company" size="42" maxlength="50" /></td>
        </tr>
        <tr class="header">
          <td class="header"><div align="left">City<span class="bodyText">*</span></div></td>
          <td><input name="city" type="text" id="city" size="42" maxlength="50" /></td>
        </tr>
        <tr class="header">
          <td class="header"><div align="left">State<span class="bodyText">*</span></div></td>
          <td><input name="state" type="text" id="state" size="42" maxlength="50" /></td>
        </tr>
        <tr class="header">
          <td class="header">Phone</td>
          <td><input name="phone" type="text" id="phone" size="42" maxlength="50" /></td>
        </tr>
        <tr class="header">
          <td class="header"><div align="left">E-Mail*</div></td>
          <td><input name="email" type="text" id="email" size="42" maxlength="50" /></td>
        </tr>
        <tr class="header">
          <td colspan="2" class="header"><div align="left">Please provide your parts requirement below: </div>            
            <textarea name="comments" cols="39" rows="4" wrap="virtual" id="comments"></textarea></td>
          </tr>
		  <tr>
                  <td colspan="2" align="center"><div align="center">
				        <img id="captcha" src="/captcha/securimage_show.php" alt="CAPTCHA Image" /><br>
                        <p>Enter The Security Code As It Appears Above:</p>
                        <input type="text" name="captcha_code" size="10" maxlength="6" />
                        <BR>
                        <a href="#" onclick="document.getElementById('captcha').src = '/captcha/securimage_show.php?' + Math.random(); return false" class="header" />Reload Image</a>
					  </div></td>
                </tr>
      </table></form>
		  <div align="center">
            <p>&nbsp;</p>
            <p>&nbsp;</p>
            <p class="header">&nbsp;</p>
          </div></td>
        </tr>
    </table>
	
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