<body>
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<div id="header">
<div id="logo">
<h1><a href="#"><span>A.P.O </span>Management</a></h1>
</div>
<div id="menu">
<ul id="main">
<li><a href="homepage.html">Main Page</a><a href="aboutus.html">About A.P.O</a></li>
<li><a href="artists.html">Artists</a><a href="mixes.html">Mixes</a></li>
<li class="current_page_item"><a href="requests.html">Booking Requests</a></li>
<li></li>
<li><a href="contactus.html">Contact Us</a></li>
</ul>
<ul id="feed">
<li></li>
<li></li>
</ul>
</div>
</div>
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<div id="wrapper">
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<div id="page">
<!-- start content -->
<center>
<form method="post" action="contact.php">
<div class="floatRight width73">
<h1>Booking Request Form <span class="dark"></span>:</h1>
<p> To help us better assist you, please fill out the following form located below. Make sure that you fill in as much information as possible. </p>
<p>One of our Artist Representatives will contact with you within 24 hours of receiving your request.</p>
<p><strong>General Information </strong></p>
<p>
<label>Date of Event:</label>
<select name="eventmonth" id="eventmonth">
<option>Month</option>
<option>January</option>
<option>February</option>
<option>March</option>
<option>April</option>
<option>May</option>
<option>June</option>
<option>July</option>
<option>August</option>
<option>September</option>
<option>October</option>
<option>November</option>
<option>December</option>
</select>
<select name="eventday"id="eventday">
<option>Day</option>
<option>01</option>
<option>02</option>
<option>03</option>
<option>04</option>
<option>05</option>
<option>06</option>
<option>07</option>
<option>08</option>
<option>09</option>
<option>10</option>
<option>11</option>
<option>12</option>
<option>13</option>
<option>14</option>
<option>15</option>
<option>16</option>
<option>17</option>
<option>18</option>
<option>19</option>
<option>20</option>
<option>21</option>
<option>22</option>
<option>23</option>
<option>24</option>
<option>25</option>
<option>26</option>
<option>27</option>
<option>28</option>
<option>29</option>
<option>30</option>
<option>31</option>
</select>
<select name="eventyear" id="eventyear">
<option>Year</option>
<option>2009</option>
<option>2010</option>
</select>
</label>
<br />
<br />
Proposed set time:</label>
<input name="startsettime" type="text" class="width75" id="startsettime" onfocus="clearValue(this, 'other');" onblur="fillValue(this, 'other');" value="" size="6"/>
<label>
<input type="checkbox" name="am" value="checkbox" id="am" />
am
<input type="checkbox" name="pm" value="checkbox" id="pm" />
pm</label>
-UNTIL-
<input name="endsettime" type="text" class="width75" id="endsettime" onfocus="clearValue(this, 'other');" onblur="fillValue(this, 'other');" value="" size="6"/>
<input type="checkbox" name="am1" value="checkbox" id="am1" />
am
<input type="checkbox" name="pm1" value="checkbox" id="pm1" />
pm<br />
</p>
<p>
<label>Artist you are interested in booking:</label>
<select name="selectartist">
<option value="Select an Artist">Select an Artist</option>
<option value="Oliver Moldan">Oliver Moldan</option>
<option value="Betty Bizzare">Betty Bizzare</option>
<option value="Mark Holmes">Mark Holmes</option>
</select>
</p>
<p> </p>
<p><strong>Your Information </strong>:</p>
<p>
<label>First Name:</label>
<input name="firstname" type="text" class="width75" id="firstname" onfocus="clearValue(this, 'firstName');" onblur="fillValue(this, 'firstName');" value=""/>
<label> Last Name:</label>
<input name="lastname" type="text" class="width75" id="lastname" onfocus="clearValue(this, 'lastName');" onblur="fillValue(this, 'lastName');" value=""/>
<label>E-mail Address:</label>
<input name="youremail" type="text" class="width75" id="youremail" onfocus="clearValue(this, 'youremail');" onblur="fillValue(this, 'youremail');" value="*must be valid*"/>
</p>
<p>
<label>Company Name:</label>
<input name="company" type="text" class="width75" id="company" onfocus="clearValue(this, 'company');" onblur="fillValue(this, 'company');" value=""/>
<label>Address:</label>
<input name="streetaddress" type="text" class="width75" id="streetaddress" onfocus="clearValue(this, 'streetaddress');" onblur="fillValue(this, 'streetaddress');" value=""/>
<label>City:</label>
<input name="city" type="text" class="width75" id="city" onfocus="clearValue(this, 'city');" onblur="fillValue(this, 'city');" value=""/>
<label>State/Province:</label>
<input name="stateprovince" type="text" class="width75" id="stateprovince" onfocus="clearValue(this, 'stateprovince');" onblur="fillValue(this, 'stateprovince');" value="" size="10" maxlength="30"/>
</p>
<p>
<label>Country:</label>
<input name="country" type="text" class="width75" id="country" onfocus="clearValue(this, 'country');" onblur="fillValue(this, 'country');" value=""/>
<label>Postal Code:</label>
<input name="postalcode" type="text" class="width75" id="postalcode" onfocus="clearValue(this, 'postalcode');" onblur="fillValue(this, 'postalcode');" value=""/>
<label>Company Website:</label>
<input type="text" name="companywebsite" value="" class="width75" onfocus="clearValue(this, 'companywebsite');" onblur="fillValue(this, 'companywebsite');"/>
</p>
<p>
<label>Cellular Telephone #:</label>
<input name="cellulartelephone" type="text" class="width75" id="cellulartelephone" onfocus="clearValue(this, 'cellulartelephone');" onblur="fillValue(this, 'cellulartelephone');" value="no dashes please"/>
<label>Business Telephone #:</label>
<input name="businesstelephone" type="text" class="width75" id="businesstelephone" onfocus="clearValue(this, 'businesstelephone');" onblur="fillValue(this, 'businesstelephone');" value="no dashes please"/>
<label>Business Fax #:</label>
<input name="businessfax" type="text" class="width75" id="businessfax" onfocus="clearValue(this, 'businessfax');" onblur="fillValue(this, 'businessfax');" value="no dashes please"/>
</p>
<p> </p>
<p><strong>Venue Information </strong>:</p>
<p>
<label>Proposed Venue Name:</label>
<input name="venuename" type="text" class="width75" id="venuename" onfocus="clearValue(this, 'venuename');" onblur="fillValue(this, 'venuename');" value=""/>
<label>Venue Capacity:</label>
<input name="venuecapacity" type="text" class="width75" id="venuecapacity" onfocus="clearValue(this, 'venuecapacity');" onblur="fillValue(this, 'venuecapacity');" value="" size="7"/>
<label>Age Restrictions:</label>
<select name="agerestrictions" >
<option value="Please Select">Please Select </option>
<option value="All Ages">All Ages</option>
<option value="18+">18+</option>
<option value="21+">21+</option>
<option value="Other">Other</option>
</select>
<label> **If other please explain:</label>
<input name="other" type="text" class="width75" onfocus="clearValue(this, 'other');" onblur="fillValue(this, 'other');" value="" size="20" maxlength="30"/>
</p>
<p>
<label>Address of Venue:</label>
<input name="venuestreetaddress" type="text" class="width75" id="venuestreetaddress" onfocus="clearValue(this, 'venuestreetaddress');" onblur="fillValue(this, 'venuestreetaddress');" value=""/>
<label>City:</label>
<input name="venuecity" type="text" class="width75" id="venuecity" onfocus="clearValue(this, 'venuecity');" onblur="fillValue(this, 'venuecity');" value=""/>
<label>State/Province:</label>
<input name="venuestateprovince" type="text" class="width75" id="venuestateprovince" onfocus="clearValue(this, 'venuestateprovince');" onblur="fillValue(this, 'venuestateprovince');" value="" size="10" maxlength="40"/>
<label>Country:
<input name="venuecountry" type="text" class="width75" id="venuecountry" onfocus="clearValue(this, 'venuecountry');" onblur="fillValue(this, 'venuecountry');" value="" size="15" maxlength="40"/>
Postal Code:</label>
<input name="venuepostalcode" type="text" class="width75" id="venuepostalcode" onfocus="clearValue(this, 'venuepostalcode');" onblur="fillValue(this, 'venuepostalcode');" value="" size="10"/>
</p>
<p>
<label></label>
<label>Venue Telephone #:</label>
<input name="venuetelephone" type="text" class="width75" id="venuetelephone" onfocus="clearValue(this, 'venuetelephone');" onblur="fillValue(this, 'venuetelephone');" value="no dashes please"/>
<label>Venue Fax #:</label>
<input name="venuefax" type="text" class="width75" id="venuefax" onfocus="clearValue(this, 'venuefax');" onblur="fillValue(this, 'venuefax');" value="no dashes please"/>
<label>Venue Website:</label>
<input type="text" name="venuewebsite" value="" class="width75" onfocus="clearValue(this, 'venuewebsite');" onblur="fillValue(this, 'venuewebsite');"/>
</p>
<p>
<label>
<label>Venue Contact First Name:</label>
<input name="venuecontactfirstname" type="text" class="width75" id="venuecontactfirstname" onfocus="clearValue(this, 'venuecontactfirstname');" onblur="fillValue(this, 'venuecontactfirstname');" value=""/>
</label>
<label>Last Name:</label>
<input name="venuecontactlastname" type="text" class="width75" id="venuecontactlastname" onfocus="clearValue(this, 'venuecontactlastname');" onblur="fillValue(this, 'venuecontactlastname');" value=""/>
<label>Contact #:</label>
<input name="venuecontactphone" type="text" class="width75" id="venuecontactphone" onfocus="clearValue(this, 'venuecontactphone');" onblur="fillValue(this, 'venuecontactphone');" value=""/>
</p>
<p> </p>
<p>
<label>**PLEASE MAKE SURE ALL INFORMATION ABOVE IS CORRECT BEFORE SUBMITTING THIS FORM**</label>
</p>
<p>
<label>
<input type="submit" name="Submit" id="Submit" value="Submit" />
</label>
</p>
</div>
<br />
</form>
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<div style="clear: both;"> </div>
</div>
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</div>
<div id="footer">
<p class="copyright">© 2009 All Rights Reserved • Designed by A.P.O Graphix</p>
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