A representative will call you and answer your questions <BR>
	<BR>
      <form name="form1" method="post" action="http://www.heatingonline.com/efhmailh/call2mail.php3">
        <table width="60%"  border="0" cellspacing="0" cellpadding="3">
          <tr>
            <td>name </td>
            <td><input type="text" name="client_name"></td>
          </tr>
          <tr>
            <td>number</td>
            <td><input type="text" name="areacode" size="4" maxlength="4">-<input type="text" name="seven_digits" size="6" maxlength="7"></td>
          </tr>
          <tr>
            <td>good time to call </td>
            <td><select name="timetocall">
              <option value="0">Right Now</option>
              <option value="1">In an Hour</option>
              <option value="4">In four hours</option>
              <option value="24">tommorow</option>
            </select></td>
          </tr>
          <tr>
            <td align="left" valign="top">Comments</td>
            <td><textarea name="comments" rows="6" cols="30"></textarea></td>
          </tr>
        </table>
        <br>
        <input type="submit" name="Submit" value="Submit">
                <input name="origin" type="hidden" value="http://www.floorheatech.co.uk/heat/call.php">
		<input name="refer" type="hidden" value="">
                <input name="source" type="hidden" value="UK">
		<input name="thankyou" type="hidden" value="http://www.floorheatech.co.uk/thankyou.php">
      </form>
      <br>