Mailing List

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" rowspan="2" width=210 BGCOLOR="#99CC99" TEXT="#080000" bgproperties="fixed" background="0a88dfc3.jpg"> <div> <B>Sign up for our mailing list and receive news of upcoming tastings, wine dinners and other wine related events.</B></div> <bR> <div> <B>OUR PROMISE: We will share your personal informa-</B></div> <div> <B>tion with NO ONE!</B></div> <bR> <div> <B>You can contact us at: 847-247-0004 if you want more information.</B></div> <bR> <bR> </td> <td valign="top" colspan=2 height=82 BGCOLOR="#CCCC99" TEXT="#080000" bgproperties="fixed" background="0a98dfe1esnpes.jpg"> <div> <FONT SIZE="5" COLOR="#000000" FACE="Arial" ><B>Viva le Vine</B></FONT><B>     </B><B>|</B><B>     </B><A HREF="index.htm" TARGET="_top" TITLE="Viva le Vine"><U><B>home</B></U></A></div> <div> <A HREF="about_viva_le_vine.htm" TARGET="_top" TITLE="About Us"><U>About Us</U></A>   |   <A HREF="products___services.htm" TARGET="_top" TITLE="Products and Services"><U>Products and Services</U></A>   |   <A HREF="wine_sale.htm" TARGET="_top" TITLE="Wedding Gifts for Wine Lovers"><U>Wedding Gifts for Wine Lovers</U></A>   |   <A HREF="wine_tasting.htm" TARGET="_top" TITLE="Monthly Wine Tasting Events"><U>Monthly Wine Tasting Events</U></A>   |   <A HREF="selection_of_cheeses_from_around_the_world.htm" TARGET="_top" TITLE="Fine Cheeses"><U>Fine Cheeses</U></A>   |   <A HREF="custom_gift_baskets.htm" TARGET="_top" TITLE="Gift Baskets / Gift Registry"><U>Gift Baskets / Gift Registry</U></A>   |   <A HREF="id21.htm" TARGET="_top" TITLE="Oregon Wine Country Lodging"><U>Oregon Wine Country Lodging</U></A>   |   <A HREF="id22.htm" TARGET="_top" TITLE="Special Wine Sale Items"><U>Special Wine Sale Items</U></A>   |   <A HREF="id23.htm" TARGET="_top" TITLE="9th ANNUAL PIG ROAST / WINE TASTING"><U>9th ANNUAL PIG ROAST / WINE TASTING</U></A>   |   <B>Mailing List</B>   |   <A HREF="id25.htm" TARGET="_top" TITLE="Riedel Crystal SALE!"><U>Riedel Crystal SALE!</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" height=398 colspan=2 BGCOLOR="#CCCC99" TEXT="#080000" bgproperties="fixed" background="0a98dfc3.jpg"> <div> <I>Mailing List Sign-Up</I></div> <bR> <div> <I> <form action="http://csbmail.globalscape.com/cgi-bin/csbmail/csbmail.pl" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="FirstName,LastName,Email,Address1,Address2,City,State,Zip,Phone,MailingList,Comments"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="You will be added to our mailing list. Be assured that we share your information with no one."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="A request form was submitted"><input type="hidden" name="tlx_EmailTo" value="vivamarcella@hotmail.com"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">First Name:<br> <input type="text" name="FirstName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Last Name:<br> <input type="text" name="LastName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 1:<br> <input type="text" name="Address1" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 2:<br> <input type="text" name="Address2" size="30" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Zip:<br> <input type="text" name="Zip" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td> <input type="checkbox" name="MailingList" value="yes"> Add me to your mailing list</td> </tr> <tr> <td align="left">Comments:<br> <textarea name="Comments" rows="5" cols="30"></textarea></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </I></div> <bR> </td> </tr></table></body>