#!/bin/sh echo Content-type: text/html cat << EOM1 Request Form for Shannon Jacobs
Request Form for Shannon Jacobs

You can use this form to send me a structured email message. Hopefully, it's pretty obvious how to use it, but just in case... You fill in the blanks, and in the places where there is a selection button, you click on the button to see the selections, then click on your choice. If you can't make this work correctly with your Web browser, shanen@iac.co.jp and sysop.shanen@bbsmail.iac.co.jp are my email addresses for regular email.

By the way, how did you find my home page?
It came up in a search engine [Which one and what search?]
Hit a link to it somewhere [Where?]
From your business card
Saw a newsgroup article
Someone told me it was worth a visit
My psychic power told me to come
Wouldn't you like to know?

Your name:
Your email address:
Check this box if you need me to respond via phone
Your (Japanese) Daytime Voice Phone Number:
What Kind of Request?

Your comments:

Also feel free to contact me directly at: shanen@iac.co.jp