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<html><head><title>Untitled Document</title><meta http-equiv="Content-Type" content="text/html; charset=euc-kr"></head><body bgcolor="#FFFFFF" text="#000000"><table width="700" border="0" cellspacing="0"> <tr> <td width="13"> </td> <td width="683"><img src="http://networkbiz.co.kr/hwangsam/index.jpg" width="651" height="1130"></td> </tr> <tr> <td width="13"> </td> <td width="683"> <form name="form1" method="post" action="http://www.networkbiz.co.kr/hwangsam/w_app.php"> <div align="center"><b><font size="5"><br> * 상담신청서작성 *</font></b><br> </div> <table width="613" border="0" cellpadding="1" align="center"> <tr> <td bgcolor="#999999" width="607"> <table width="100%" border="0" cellspacing="1" cellpadding="3"> <tr bgcolor="#FFFFFF"> <td width="20%" bgcolor="#eeeeee"> <div align="center"><font size="2">이 름 <input type="hidden" name="senddata" value="ok"> </font></div> </td> <td width="24%"> <font size="2"> <input type="text" name="name" size="15"> </font></td> <td width="10%" bgcolor="#eeeeee"> <div align="center"><font size="2">나이 </font></div> </td> <td width="8%"> <font size="2"> <input type="text" name="age" size="3"> </font></td> <td width="12%" bgcolor="#eeeeee"> <div align="center"><font size="2">성 별</font></div> </td> <td width="26%"> <font size="2"> <input type="radio" name="sex" value="남"> 남 <input type="radio" name="sex" value="여"> 여 </font></td> </tr> <tr bgcolor="#FFFFFF"> <td width="20%" bgcolor="#eeeeee"> <div align="center"><font size="2">직 업</font></div> </td> <td colspan="5" bgcolor="#FFFFFF"> <font size="2"> <input type="text" name="job"> </font><font size="2"></font><font size="2"></font></td> </tr> <tr bgcolor="#FFFFFF"> <td width="20%" bgcolor="#eeeeee"> <div align="center"><font size="2">주 소</font></div> </td> <td colspan="5" bgcolor="#FFFFFF"><font size="2"> 우편번호 <input type="text" name="zip1" size="3"> - <input type="text" name="zip2" size="3"> <br> 주소 <input type="text" name="address" size="50"> </font></td> </tr> <tr bgcolor="#FFFFFF"> <td width="20%" bgcolor="#eeeeee"> <div align="center"><font size="2">전 화 번 호</font></div> </td> <td colspan="5" bgcolor="#FFFFFF"> <font size="2"> <input type="text" name="phone1" size="3"> - <input type="text" name="phone2" size="4"> - <input type="text" name="phone3" size="4"> </font></td> </tr> <tr bgcolor="#FFFFFF"> <td width="20%" bgcolor="#eeeeee"> <div align="center"><font size="2">휴대폰</font></div> </td> <td colspan="5" bgcolor="#FFFFFF"> <font size="2"> <input type="text" name="hp1" size="3" value=""> - <input type="text" name="hp2" size="4"> - <input type="text" name="hp3" size="4"> </font></td> </tr> <tr bgcolor="#FFFFFF"> <td width="20%" bgcolor="#eeeeee"> <div align="center"><font size="2">결혼여부</font></div> </td> <td colspan="5" bgcolor="#FFFFFF"> <font size="2"> </font><font size="2"></font><font size="2"> <input type="radio" name="marrage" value="기혼"> 기혼 <input type="radio" name="marrage" value="미혼"> 미혼 </font></td> </tr> <tr bgcolor="#FFFFFF"> <td width="20%" bgcolor="#eeeeee"> <div align="center"><font size="2">내 용</font></div> </td> <td colspan="5" bgcolor="#FFFFFF"><font size="2"> <textarea name="contents" cols="50" rows="5">
