<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
<HTML><HEAD>
<META content="text/html; charset=unicode" http-equiv=Content-Type>
<META name=GENERATOR content="MSHTML 8.00.7600.16490"></HEAD>
<BODY>
<TABLE border=2 cellSpacing=1 summary="" cellPadding=1 width=200 align=center>
  <TBODY>
  <TR>
    <TD bgColor=#ffff99 borderColor=#840000>
      <P align=center><IMG alt="lalakoi newsletter" 
      src="http://www.lalakoi.com/mymailer/lalakoinewsletter640.jpg"></P>
      <P align=center><FONT color=#840000 face=Tahoma><STRONG>Welcome to the 
      Lalakoi Newsletter Subscription Form</STRONG></FONT></P>
      <P align=center><STRONG><FONT color=#840000 size=2 face=Tahoma>Fields 
      marked with (*) are required</FONT></STRONG></P><!--
Do not modify the NAME value of any of the INPUT fields
the FORM action, or any of the hidden fields (eg. input type=hidden).
These are all required for this form to function correctly.
-->
      <STYLE type=text/css>
 .myForm td, input, select, textarea, checkbox  {
  font-family: tahoma;
  font-size: 12px;
 }
 .required {
  color: red;
 }</STYLE>

      <FORM id=frmSS2 onsubmit="return CheckForm2(this);" method=post 
      action=http://lalakoi.my-mailer.com/form.php?form=2>
      <TABLE class=myForm border=0 cellPadding=2>
        <TBODY>
        <TR>
          <TD><SPAN class=required>*</SPAN>&nbsp; <FONT 
            color=#840000><STRONG>Your Email Address:</STRONG></FONT></TD>
          <TD><INPUT name=email></TD></TR>
        <TR>
          <TD>&nbsp;&nbsp;&nbsp;&nbsp;<FONT 
            color=#840000><STRONG>Title:</STRONG></FONT></TD>
          <TD><SELECT id=CustomFields_1_2 name=CustomFields[1]> <OPTION 
              selected value=""></OPTION> <OPTION value=Ms>Ms</OPTION> <OPTION 
              value=Mrs>Mrs</OPTION> <OPTION value=Mr>Mr</OPTION> <OPTION 
              value=Dr>Dr</OPTION> <OPTION value=Prof>Prof</OPTION></SELECT></TD></TR>
        <TR>
          <TD><SPAN class=required>*</SPAN>&nbsp; <FONT 
            color=#840000><STRONG>First Name:</STRONG></FONT></TD>
          <TD><INPUT id=CustomFields_2_2 size=50 name=CustomFields[2]></TD></TR>
        <TR>
          <TD><SPAN class=required>*</SPAN>&nbsp; <FONT 
            color=#840000><STRONG>Last Name:</STRONG></FONT></TD>
          <TD><INPUT id=CustomFields_3_2 size=50 name=CustomFields[3]></TD></TR>
        <TR>
          <TD>&nbsp;&nbsp;&nbsp;&nbsp;<FONT 
            color=#840000><STRONG>City:</STRONG></FONT></TD>
          <TD><INPUT id=CustomFields_8_2 size=50 name=CustomFields[8]></TD></TR>
        <TR>
          <TD><SPAN class=required>*</SPAN>&nbsp; <FONT 
            color=#840000><STRONG>Country:</STRONG></FONT></TD>
          <TD><INPUT id=CustomFields_17_2 name=CustomFields[17]></TD></TR>
        <TR>
          <TD><FONT color=#840000><STRONG></STRONG></FONT></TD>
          <TD>
            <SCRIPT type=text/javascript>
   // <![CDATA[
    var SIDString = '';
    function getRandomLetter() {
     return String.fromCharCode(getRandom(65, 90));
    }
    function getRandom(lowerBound, upperBound) {
     return Math.floor((upperBound - lowerBound + 1) * Math.random() + lowerBound);
    }
    function SetSID()
    {
     if (SIDString.length > 0)
     {
      return SIDString;
     }
     sidc = 0;
     while (sidc < 32)
     {
      SIDString = SIDString + getRandomLetter();
      sidc++;
     }
     return SIDString;
    }
   // ]]>
   </SCRIPT>

            <SCRIPT type=text/javascript>
     // <![CDATA[
     var url = "http://lalakoi.my-mailer.com/admin/resources/form_designs/captcha/index.php?c=" + getRandom(1,1000)+ "&ss=" + SetSID();
      document.write("<" + "img src='" + url + "' alt='img'/>");
     // ]]>
     </SCRIPT>
          </TD></TR>
        <TR>
          <TD>&nbsp;</TD>
          <TD><INPUT value=Subscribe type=submit> 
      <BR></TD></TR></TBODY></TABLE></FORM>
      <SCRIPT type=text/javascript>
// <![CDATA[
   function CheckMultiple2(frm, name) {
    for (var i=0; i < frm.length; i++)
    {
     fldObj = frm.elements[i];
     fldId = fldObj.id;
     if (fldId) {
      var fieldnamecheck=fldObj.id.indexOf(name);
      if (fieldnamecheck != -1) {
       if (fldObj.checked) {
        return true;
       }
      }
     }
    }
    return false;
   }
  function CheckForm2(f) {
   var email_re = /[a-z0-9!#$%&'*+\/=?^_`{|}~-]+(?:\.[a-z0-9!#$%&'*+\/=?^_`{|}~-]+)*@(?:[a-z0-9](?:[a-z0-9-]*[a-z0-9])?\.)+[a-z0-9](?:[a-z0-9-]*[a-z0-9])?/i;
   if (!email_re.test(f.email.value)) {
    alert("Please enter your email address.");
    f.email.focus();
    return false;
   }
  
    if (f.captcha.value == "") {
     alert("Please enter the security code shown");
     f.captcha.focus();
     return false;
    }
   
   var fname = "CustomFields_2_2";
   var fld = document.getElementById(fname);
   if (fld.value == "") {
    alert("Please enter a value for field First Name");
    fld.focus();
    return false;
   }
  
   var fname = "CustomFields_3_2";
   var fld = document.getElementById(fname);
   if (fld.value == "") {
    alert("Please enter a value for field Last Name");
    fld.focus();
    return false;
   }
  
   var fname = "CustomFields_17_2";
   var fld = document.getElementById(fname);
   if (fld.value == "") {
    alert("Please enter a value for field Country");
    fld.focus();
    return false;
   }
  
    return true;
   }
  
// ]]>
</SCRIPT>

      <P align=center>&nbsp;</P>
      <P align=center>&nbsp;</P></TD></TR></TBODY></TABLE></BODY></HTML>