Your IP : 18.217.204.60
<script type="text/javascript" src="scripts/carrier-ticker.js"></script>
<script type="text/javascript">
$(function(){
$('#carrier-list').totemticker({
row_height : '150px',
mousestop : true,
});
});
</script>
<div class="form-shell">
<? if ($page_title!=$page_title_contact) { ?>
<div class="widget">
<h4>Contact Us</h4>
<div class="widget-rule"></div>
<center>
<div class="widget-form">
<form method="post" action="contact.php" id="widget-form" class="form-horizontal">
<div class="widget-row">
<div class="field">
<input name="Name" type="text" class="input-medium required" id="Name" placeholder="NAME">
</div>
</div>
<div class="widget-row">
<div class="field">
<input name="Phone" type="text" class="input-medium" id="Phone" placeholder="PHONE">
</div>
</div>
<div class="widget-row">
<div class="field">
<input name="Email" type="text" class="input-medium" id="Email" placeholder="EMAIL">
</div>
</div>
<div class="widget-row">
<div class="field">
<textarea class="input-large" name="Comments" id="Comments" rows="7"></textarea>
</div>
</div>
<div class="clear"></div>
<div style="padding: 5px 0 0 20px; margin-left:-20px;">
<button type="submit" id="submit" class="btn btn-small" value="Submit" onclick="submitForm();return false;">Submit</button>
<button type="reset" class="btn btn-small">Cancel</button>
</div>
</form>
</div>
</center>
</div>
<!--{ end widget -->
<? } else { ?>
<? } ?>
<div class="clear"></div>
<div style="clear:both;"></div>
</div>
<!--end form-shell-->
<div style="clear:both;"></div>