<form id="emf-form" enctype="multipart/form-data" method="post" action="http://www.emailmeform.com/builder/form/BSoMjJxz8c32E049bd4N" name="emf-form">
<table style="text-align:left;" cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF">
<tr>
<td style="" colspan="2">
<font face="Verdana" size="2" color="#000000"><b style="font-size:20px;">upload file anda</b><br />
<label style="font-size:15px;">upload lah cerita panas anda dan berpeluang memenangi wang tunai rm200<br /></label><br /></font>
</td>
</tr>
<tr valign="top">
<td id="td_element_label_0" style="" align="left">
<font face="Verdana" size="2" color="#000000"><b>Name</b></font>
</td>
<td id="td_element_field_0" style="">
<table cellpadding='0' cellspacing='0' border='0'>
<tr>
<td align='center' style='padding-left:0;padding-right:3px;'>
<input style='width:60px;' value='' id='element_0_2' name='element_0[]' type='text' class='validate[optional]' /><br />
<font face="Verdana" size="2" color="#000000">First</font>
</td>
<td align='center' style='padding-left:0;'>
<input style='width:100px;' value='' id='element_0_3' name='element_0[]' type='text' class='validate[optional]' /><br />
<font face="Verdana" size="2" color="#000000">Last</font>
</td>
</tr>
</table>
<div style="padding-bottom:8px;color:#000000;">
<small><font face="Verdana">nama sebenar atau samaran</font></small>
</div>
</td>
</tr>
<tr valign="top">
<td id="td_element_label_1" style="" align="left">
<font face="Verdana" size="2" color="#000000"><b>File Upload</b></font>
</td>
<td id="td_element_field_1" style="">
<input id="element_1" name="element_1" class="validate[optional]" type="file" />
<div style="padding-bottom:8px;color:#000000;">
<small><font face="Verdana">file mestilah mengikut format txt.doc dan lain-lain</font></small>
</div>
</td>
</tr>
<tr valign="top">
<td id="td_element_label_2" style="" align="left">
<font face="Verdana" size="2" color="#000000"><b>your email</b></font>
</td>
<td id="td_element_field_2" style="">
<input id="element_2" name="element_2" class="validate[optional,custom[email]]" value="" size="30" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr>
<td colspan="2" align="left">
<input name="element_counts" value="3" type="hidden" /> <input name="embed" value="forms" type="hidden" /><input value="Send email" type="submit" />
</td>
</tr>
</table>
</form>
<div>
<font face="Verdana" size="2" color="#000000">Powered by</font><span style="position: relative; padding-left: 3px; bottom: -5px;"><img src=
"http://www.emailmeform.com/builder/images/footer-logo.png" /></span><font face="Verdana" size="2" color="#000000">EMF</font> <a style="text-decoration:none;" href="http://www.emailmeform.com/"
target="_blank"><font face="Verdana" size="2" color="#000000">Forms Builder</font></a>
</div><a style="line-height:20px;font-size:70%;text-decoration:none;" href="http://www.emailmeform.com/report-abuse.html?http://www.emailmeform.com/builder/form/BSoMjJxz8c32E049bd4N" target=
"_blank"><font face="Verdana" size="2" color="#000000">Report Abuse</font></a>
