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<title>Zodiac Feedback</title>
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<h1 style="text-align:center">Zodiac Feedback Form</h1>
<p>Please help us improve our Web site by filling out this form and giving us your feedback.
You may check the Publicly Displayed box to have your feedback displayed."</p>
<form name="feedback" action="process_zodiac_feedback.php" method="post">
<p>Name<br /><input type="text" name="name" /></p>
<p>Comments<br /><textarea name="comments" rows="10" cols="50"></textarea></p>
<p>Check here to publicly display message.<input type="checkbox" name="pubdisplay" /></p>
<p><input type="reset" value="Clear Form" />
<input type="submit" name="Submit" value="Send Form" /></p>
</form>
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