Sign up for the Chamber of Commerce Newsletter
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    <table width="278" border="0" cellspacing="0" cellpadding="0">
      <tr>
        <td width="108">Name</td>
        <td width="170"><input name="name" type="text" id="name"></td>
      </tr>
      <tr>
        <td>Phone Number </td>
        <td><input name="phone" type="text" id="phone"></td>
      </tr>
      <tr>
        <td>Email Address </td>
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      </tr>
      <tr>
        <td>Address</td>
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      </tr>
      <tr>
        <td>City </td>
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      </tr>
      <tr>
        <td>State</td>
        <td><input name="state" type="text" id="state"></td>
      </tr>
      <tr>
        <td>Zip</td>
        <td><input name="zip" type="text" id="zip"></td>
      </tr>
  </table>
    <p>How would you like your newsletter delivered?</p>
    <p>
      <input name="plain_text" type="checkbox" id="plain_text" value="checkbox">
    Plain Text 
    <input name="html" type="checkbox" id="html" value="checkbox">
    HTML    </p>
    <p>

    
<input type = "hidden" name = "email_to" value = "rlomberger@ibctv.com">  
    <input type = "hidden" name = "subject" value = "Chamber of Commerce Newsletter">
    <input type="hidden" name="mailing_list_id" value="28" />
    <input type="submit" name="Submit" value="Submit">
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