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<form action="http://cts.bedfordma.gov/subscribe/subscribe.tml" method="POST">
<table border=0 cellspacing=0 cellpadding=3>
<tr>
<td align="right">
<font size=1>Email address: </font>
</td>
<td>
<input type="text" name="email" value="" SIZE=10>
</td>
<td>
<input type="image" border="0" height="19" width="73" title="subscribe" alt="subscribe" src="http://cts.bedfordma.gov/img/english/button_subscribe.gif" name="subscribe" align="left">
</td>
</tr>
<tr>
<td align="right">
<font size=1><I>(required)</I> Your name: </font>
</td>
<td>
<INPUT TYPE="text" NAME="name" VALUE="" SIZE=10 MAXLENGTH=100>
</td>
</tr>
<tr>
<td></td><td>
<font size=1>
<input type="checkbox" name="list" value="affhousing" CHECKED >affhousing<br>
<input type="checkbox" name="list" value="meetings">meetings<br>
<input type="checkbox" name="list" value="newsupd">newsupd<br>
</font>
</td>
</tr>
</table>
<input type="hidden" name="name_required" value="T">
<input type="hidden" name="confirm" value="one">
<input type="hidden" name="showconfirm" value="T">
</form>
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