<html>
<head>
<title>arclab MailMe! Sample D - EMail registration with country selection</title>
</head>
<body>

<form action="/cgi-bin/MailMe.exe" method="POST" name="Sample D">

<input type="hidden" name="MAILME_FROM" value="me@myserver.xxx">
<input type="hidden" name="MAILME_TO" value="feedback@myserver.xxx">
<input type="hidden" name="MAILME_SERVER" value="mail.myserver.xxx">
<input type="hidden" name="MAILME_SUBJECT" value="message-sample">
<input type="hidden" name="MAILME_SUCCESS" value="success.htm">
<input type="hidden" name="MAILME_REQUIRED" value="required.htm">
<input type="hidden" name="MAILME_ERROR" value="error.htm">
<input type="hidden" name="MAILME_BLIST" value="blocked.htm">
<input type="hidden" name="MAILME_BLISTDEF" value="Country">
<input type="hidden" name="MAILME_BLISTADD_1" value="Country C">
<input type="hidden" name="MAILME_BLISTADD_2" value="Country E">
<input type="hidden" name="MAILME_BLISTADD_3" value="Country F">
<input type="hidden" name="MAILME_BLISTADD_4" value="Country I">
<input type="hidden" name="MAILME_BLISTADD_5" value="other">

<p>
Please enter your email address: (required)
</p>
<p>
<input type="text" size="35" name="_REQ__EMAIL_EMailAddress">
</p>

<p>
Please select your country:<BR>
This service is only available in Country A, B, D, G, H, J 
</p>
<p>
<select name="Country" size="1">
<option selected value="Country A">Country A</option>
<option value="Country B">Country B</option>
<option value="Country C">Country C</option>
<option value="Country D">Country D</option>
<option value="Country E">Country E</option>
<option value="Country F">Country F</option>
<option value="Country G">Country G</option>
<option value="Country H">Country H</option>
<option value="Country I">Country I</option>
<option value="Country J">Country J</option>
<option value="other">other</option>
</select>
</p>
<input type="submit" name="_IGNORE_Send" value="Send">
</form>

</body>
</html>