<?php

include_once('class.phpmailer.php'); #file include for sending email through a class.

 

if(isset($_POST['submit']) && $_POST['submit']=='Send')
{

 $admin_email ="MadisonCrewLimo@aol.com";
 
 $err1 = '';
  $mail    = new PHPMailer();
  
  $mail->From     = $_POST['email'];
  $mail->FromName = $_POST['Name'];
  
  $mail->Subject = "Reservation request from ".$_POST['Name'];
  $topic = "Reservation request from ".$_POST['Name'];
  
  $mail->AltBody = "To view the message, please use an HTML compatible email viewer!"; // optional, comment out and test

  $server_name = $_SERVER['SERVER_NAME'];
  $mail->Body       =       
    "Name:      ".$_POST['Name']."<br>
    Email:      ".$_POST['email']."<br>
    Date:      ".$_POST['date']."<br>
    Phone:      ".$_POST['phone']."<br>
    Pick Up Time:    ".$_POST['Time_hour0'].":".$_POST['Time_minute0']." ".$_POST['Time_period0']."<br>
    Number of Passengers:  ".$_POST['NumPassengers1']."<br>
    Vehicle:     ".$_POST['VehicleType1']."<br><br>
    
    
    
    <b>Pick Up Information:</b> <br>
    Address:       ".$_POST['PickupAddress']."<br>
    City:        ".$_POST['PickupCity']."<br>
    State:        ".$_POST['PickupState']."<br>
    Zip:        ".$_POST['Pickupzip']."<br>
    
    <b>Airport:</b> <br>
    Airport Name:      ".$_POST['PickupAirport']."<br>
    Airline:       ".$_POST['PickupAirline']."<br>
    Flight Number:      ".$_POST['PickupFlightNum']."<br>
    Arrival Time:      ".$_POST['PickupArrivalTime_hour'].":".$_POST['PickupArrivalTime_minute']." ".$_POST['PickupArrivalTime_period']."<br>
    
    <b>Drop Off Information:</b> <br>
    Address:       ".$_POST['DropoffAddress']."<br>
    City:        ".$_POST['DropoffCity']."<br>
    State:        ".$_POST['DropoffState']."<br>
    Zip:        ".$_POST['Dropoffzip']."<br>
    
    <b>Airport:</b> <br>
    Airport Name:      ".$_POST['DropoffAirport']."<br>
    Airline:       ".$_POST['DropoffAirline']."<br>
    
    Departure Time:      ".$_POST['DropoffDepartureTime_hour'].":".$_POST['DropoffDepartureTim_minute']." ".$_POST['DropoffDepartureTim_period']."<br>
    
    <b>Billing Information:</b> <br>
    Name:        ".$_POST['BillingName']."<br>
    CC Billing Address:     ".$_POST['BillingCompany']."<br>
    Payment Method:      ".$_POST['BillingType']."<br>
    Card Number:      ".$_POST['BillingCardNum']."<br>
    Exp. Date:       ".$_POST['BillingExpDate']."<br><br>
    
    <b>Contact Information: </b><br>
    Name:         ".$_POST['ContactName']." <br><br>  
    
    
    Comment:       ".$_POST['Comments1']."
    
    <br/><br/>Regards<br/>".$_POST['Name'];
  
  
  $mail->AddAddress($admin_email, $_POST['Name']);
  
  if(!$mail->Send()) {
   $err1 =  "Failed to send message";
  } else {
  header("location:reservation.php?sent=1");
  }
  
}

if($_GET['sent']==1)
$mess="Reservation request has been sent.";
?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<title>Madison Limousine Service, Inc.</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<meta name="description" content="Madison Limousine provide limo bus and sedan service to Dulles International Airport also limo bus service through out Washington DC, Virginia and Maryland." />
<meta name="keywords" content="Limo Bus, Luxury Sedan, Executive Sedan"/>
<style type="text/css">
<!--
body,td,th {
 font-family: Arial, Helvetica, sans-serif;
 font-size: 12px;
 color: #000000;
}
body {
 background-image: url(images/bg.gif);
 margin-left: 0px;
 margin-top: 0px;
 margin-right: 0px;
 margin-bottom: 0px;
}
-->
</style>
<link href="style.css" rel="stylesheet" type="text/css" />
<script src="Scripts/AC_RunActiveContent.js" type="text/javascript"></script>
<style type="text/css">
<!--
.style1 {
 color: #000000;
 font-weight: bold;
}
-->
</style>
</head>
<body bgcolor="#FFFFFF">
<table width="804" border="0" align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td>&nbsp;</td>
    <td height="26">&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td width="10"><img id="t1" src="images/t1.gif" width="7" height="23" alt="" /></td>
    <td width="783"><img id="t2" src="images/t2.gif" width="790" height="23" alt="" /></td>
    <td width="11"><img id="t4" src="images/t3.gif" width="7" height="23" alt="" /></td>
  </tr>
  <tr>
    <td><img id="t3" src="images/t4.gif" width="7" height="91" alt="" /></td>
    <td background="images/bg-top.gif"><table width="100%" border="0" cellspacing="0" cellpadding="0">
      <tr>
        <td width="35%">&nbsp;</td>
        <td width="35%"><img src="images/logo.gif" alt="" name="logo" width="307" height="91" id="logo" /></td>
        <td width="30%" align="right" valign="bottom"><img src="images/t-links.gif" alt="" width="96" height="39" border="0" usemap="#Map"/></td>
      </tr>
    </table></td>
    <td><img id="t5" src="images/t5.gif" width="7" height="91" alt="" /></td>
  </tr>
  <tr>
    <td background="images/bg-shadow1.gif">&nbsp;</td>
    <td bgcolor="#fefefd"><table width="100%" border="0" cellspacing="0" cellpadding="0">
      <tr>
        <td><script type="text/javascript">
AC_FL_RunContent( 'codebase','http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=9,0,28,0','width','790','height','263','src','flash','quality','high','pluginspage','http://www.adobe.com/shockwave/download/download.cgi?P1_Prod_Version=ShockwaveFlash','movie','flash' ); //end AC code
</script><noscript><object classid="clsid:D27CDB6E-AE6D-11cf-96B8-444553540000" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=9,0,28,0" width="790" height="263">
          <param name="movie" value="flash.swf" />
          <param name="quality" value="high" />
          <embed src="flash.swf" quality="high" pluginspage="http://www.adobe.com/shockwave/download/download.cgi?P1_Prod_Version=ShockwaveFlash" type="application/x-shockwave-flash" width="790" height="263"></embed>
        </object></noscript></td>
      </tr>
      <tr>
        <td height="34" background="images/links-bg.gif"><table width="100%" border="0" cellspacing="0" cellpadding="0">
          <tr>
            <td width="130" align="center" class="links"><a href="index.html" style="color:#000000; text-decoration:none;">HOME</a></td>
            <td width="1" align="center"><img id="links_sep" src="images/links-sep.gif" width="3" height="36" alt="" /></td>
            <td width="130" align="center" background="images/sel-links.gif" class="links">RESERVATION</td>
            <td width="1" align="center"><img id="links_sep2" src="images/links-sep.gif" width="3" height="36" alt="" /></td>
           <td width="1" align="center"><img id="links_sep2" src="images/links-sep.gif" width="3" height="36" alt="" /></td>
            <td width="130" align="center" class="links"><a href="fleet.html" style="color:#000000; text-decoration:none;">OUR FLEET</a></td>
            <td width="1" align="center"><img id="links_sep3" src="images/links-sep.gif" width="3" height="36" alt="" /></td>
            <td width="130" align="center" class="links"><a href="services.html" style="color:#000000; text-decoration:none;">SERVICES</a></td>
            <td width="1" align="center"><img id="links_sep4" src="images/links-sep.gif" width="3" height="36" alt="" /></td>
            <td width="130" align="center" class="links"><a href="aboutus.html" style="color:#000000; text-decoration:none;">ABOUT US </a></td>
            <td width="1" align="center"><img id="links_sep5" src="images/links-sep.gif" width="3" height="36" alt="" /></td>
            <td width="130" align="center" class="links"><a href="contactus.html" style="color:#000000; text-decoration:none;">CONTACTS</a></td>
            </tr>
        </table></td>
      </tr>
      <tr>
        <td height="350" valign="top" background="images/copy-bg.gif"><table width="100%" border="0" cellspacing="0" cellpadding="0">
          <tr>
            <td>&nbsp;</td>
            <td>&nbsp;</td>
            <td>&nbsp;</td>
            <td>&nbsp;</td>
          </tr>
          <tr>
            <td width="3%"><img src="images/spacer.gif" width="20" height="1" /></td>
            <td width="66%" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0">
                <tr>
                  <td valign="top">&nbsp;</td>
                  <td>&nbsp;</td>
                </tr>
                <tr>
                  <td valign="top"><img src="images/arrow.gif" width="13" height="13" hspace="3" vspace="2" /></td>
                  <td class="texthead">RESERVATION</td>
                </tr>
                <tr>
                  <td valign="top">&nbsp;</td>
                  <td class="light">----------------------------------------------------------------------------------------------------------------------------</td>
                </tr>
                <tr>
                  <td width="3%" valign="top">&nbsp;</td>
                  <td width="97%">
<form name="reservation" method="POST" action="" >
<table cellspacing="0"  width="500"cellpadding="0">
  <TR>
    <TD colSpan="2"><p align="center"><strong><font color="#FF0000"><?=$mess;?></font><br /><br />Please fill out the form   below and click "Send" to request a reservation.<br /></strong></p></TD>
  </TR>
  <TR>
    <TD bgColor="#E8E8E8" colSpan="2" height="26"><span class="style1">Reservation Information.</span></TD>
  </TR>
  <TR>
    <TD width="246">Name: </TD>
    <TD width="394"><INPUT size="54" name="Name" value="">
    </TD>
  </TR>
  <TR>
    <TD width="246">Email: </TD>
    <TD width="394"><INPUT size="54" name="email" value="">
    </TD>
  </TR>
  <TR>
    <TD width="246">Date: </TD>
    <TD width="394"><INPUT name="date" value="">
    </TD>
  </TR>
  <TR>
    <TD width="246">Pick Up Time:</TD>
    <TD width="394"><SELECT onchange="CF_TIMEINPUT_ChangeTime (this.form, 'Time');" size="1" name="Time_hour0">
      <OPTION value="12" selected>12</OPTION>
      <OPTION value="1">1</OPTION>
      <OPTION value="2">2</OPTION>
      <OPTION value="3">3</OPTION>
      <OPTION value="4">4</OPTION>
      <OPTION value="5">5</OPTION>
      <OPTION value="6">6</OPTION>
      <OPTION value="7">7</OPTION>
      <OPTION value="8">8</OPTION>
      <OPTION value="9">9</OPTION>
      <OPTION value="10">10</OPTION>
      <OPTION value="11">11</OPTION>
    </SELECT>
      :
      <SELECT onchange="CF_TIMEINPUT_ChangeTime (this.form, 'Time');" name="Time_minute0">
        <OPTION value="0" selected>00</OPTION>
        <OPTION value="1">01</OPTION>
        <OPTION value="2">02</OPTION>
        <OPTION value="3">03</OPTION>
        <OPTION value="4">04</OPTION>
        <OPTION value="5">05</OPTION>
        <OPTION value="6">06</OPTION>
        <OPTION value="7">07</OPTION>
        <OPTION value="8">08</OPTION>
        <OPTION value="9">09</OPTION>
        <OPTION value="10">10</OPTION>
        <OPTION value="11">11</OPTION>
        <OPTION value="12">12</OPTION>
        <OPTION value="13">13</OPTION>
        <OPTION value="14">14</OPTION>
        <OPTION value="15">15</OPTION>
        <OPTION value="16">16</OPTION>
        <OPTION value="17">17</OPTION>
        <OPTION value="18">18</OPTION>
        <OPTION value="19">19</OPTION>
        <OPTION value="20">20</OPTION>
        <OPTION value="21">21</OPTION>
        <OPTION value="22">22</OPTION>
        <OPTION value="23">23</OPTION>
        <OPTION value="24">24</OPTION>
        <OPTION value="25">25</OPTION>
        <OPTION value="26">26</OPTION>
        <OPTION value="27">27</OPTION>
        <OPTION value="28">28</OPTION>
        <OPTION value="29">29</OPTION>
        <OPTION value="30">30</OPTION>
        <OPTION value="31">31</OPTION>
        <OPTION value="32">32</OPTION>
        <OPTION value="33">33</OPTION>
        <OPTION value="34">34</OPTION>
        <OPTION value="35">35</OPTION>
        <OPTION value="36">36</OPTION>
        <OPTION value="37">37</OPTION>
        <OPTION value="38">38</OPTION>
        <OPTION value="39">39</OPTION>
        <OPTION value="40">40</OPTION>
        <OPTION value="41">41</OPTION>
        <OPTION value="42">42</OPTION>
        <OPTION value="43">43</OPTION>
        <OPTION value="44">44</OPTION>
        <OPTION value="45">45</OPTION>
        <OPTION value="46">46</OPTION>
        <OPTION value="47">47</OPTION>
        <OPTION value="48">48</OPTION>
        <OPTION value="49">49</OPTION>
        <OPTION value="50">50</OPTION>
        <OPTION value="51">51</OPTION>
        <OPTION value="52">52</OPTION>
        <OPTION value="53">53</OPTION>
        <OPTION value="54">54</OPTION>
        <OPTION value="55">55</OPTION>
        <OPTION value="56">56</OPTION>
        <OPTION value="57">57</OPTION>
        <OPTION value="58">58</OPTION>
        <OPTION value="59">59</OPTION>
      </SELECT>
      <SELECT onchange="CF_TIMEINPUT_ChangeTime (this.form, 'Time');" size="1" name="Time_period0">
        <OPTION value="AM">am</OPTION>
        <OPTION value="PM" selected>pm</OPTION>
      </SELECT>
    </TD>
  </TR>
  <TR>
    <TD width="246">Phone #:</TD>
    <TD width="394"><INPUT size="30" name="phone" value=""></TD>
  </TR>
  <TR>
    <TD width="246"># of Passengers:</TD>
    <TD width="394"><INPUT size="3" name="NumPassengers1" value=""></TD>
  </TR>
  <TR>
    <TD width="246">Vehicle:</TD>
    <TD width="394"><SELECT size="1" name="VehicleType1">
      <OPTION value="Sedan" selected>Limo Bus</OPTION>
      <OPTION value="Bus">Sedan</OPTION>
    </SELECT></TD>
  </TR>
  <TR>
    <TD colSpan="2"> </TD>
  </TR>
  <TR>
    <TD  bgColor="#E8E8E8"colSpan="2" height="21"><strong>Pick Up Information</strong></TD>
  </TR>
  <!--<TR>
    <TD width="246">Select One:</TD>
    <TD width="394"> </TD>
  </TR>-->
  <TR>
    <TD colSpan="2"><em><strong>Address</strong></em></TD>
  </TR>
  <TR>
    <TD width="246">Address:</TD>
    <TD width="394"><INPUT size="54" name="PickupAddress"></TD>
  </TR>
  <TR>
    <TD width="246">City<SPAN lang="en-us">,</SPAN>State<SPAN lang="en-us">,Zip</SPAN>:</TD>
    <TD width="394"><INPUT size="26" name="PickupCity">
        <SELECT size="1" name="PickupState">
          <OPTION value="AK">AK</OPTION>
          <OPTION value="AL">AL</OPTION>
          <OPTION value="AR">AR</OPTION>
          <OPTION value="AZ">AZ</OPTION>
          <OPTION value="CA">CA</OPTION>
          <OPTION value="CO">CO</OPTION>
          <OPTION value="CT">CT</OPTION>
          <OPTION value="DC">DC</OPTION>
          <OPTION value="DE">DE</OPTION>
          <OPTION value="FL">FL</OPTION>
          <OPTION value="GA">GA</OPTION>
          <OPTION value="HI">HI</OPTION>
          <OPTION value="IA">IA</OPTION>
          <OPTION value="ID">ID</OPTION>
          <OPTION value="IL">IL</OPTION>
          <OPTION value="IN">IN</OPTION>
          <OPTION value="KS">KS</OPTION>
          <OPTION value="KY">KY</OPTION>
          <OPTION value="LA">LA</OPTION>
          <OPTION value="MA">MA</OPTION>
          <OPTION value="MD">MD</OPTION>
          <OPTION value="ME">ME</OPTION>
          <OPTION value="MI">MI</OPTION>
          <OPTION value="MN">MN</OPTION>
          <OPTION value="MO">MO</OPTION>
          <OPTION value="MS">MS</OPTION>
          <OPTION value="MT">MT</OPTION>
          <OPTION value="NC">NC</OPTION>
          <OPTION value="ND">ND</OPTION>
          <OPTION value="NE">NE</OPTION>
          <OPTION value="NH">NH</OPTION>
          <OPTION value="NJ">NJ</OPTION>
          <OPTION value="NM">NM</OPTION>
          <OPTION value="NV">NV</OPTION>
          <OPTION value="NY">NY</OPTION>
          <OPTION value="OH">OH</OPTION>
          <OPTION value="OK">OK</OPTION>
          <OPTION value="OR">OR</OPTION>
          <OPTION value="PA">PA</OPTION>
          <OPTION value="RI">RI</OPTION>
          <OPTION value="SC">SC</OPTION>
          <OPTION value="SD">SD</OPTION>
          <OPTION value="TN">TN</OPTION>
          <OPTION value="TX">TX</OPTION>
          <OPTION value="UT">UT</OPTION>
          <OPTION value="VA" selected>VA</OPTION>
          <OPTION value="VT">VT</OPTION>
          <OPTION value="WA">WA</OPTION>
          <OPTION value="WI">WI</OPTION>
          <OPTION value="WV">WV</OPTION>
          <OPTION value="WY">WY</OPTION>
        </SELECT>
        <INPUT size="14" name="Pickupzip" value=""></TD>
  </TR>
  <TR>
    <TD colSpan="2"><em><strong>Airport</strong></em></TD>
  </TR>
  <TR>
    <TD width="246">Airport Name:</TD>
    <TD width="394"><INPUT size="53" name="PickupAirport" value=""></TD>
  </TR>
  <TR>
    <TD width="246">Airline:</TD>
    <TD width="394"><SELECT name="PickupAirline">
      <OPTION value="Air Canada" selected>Air Canada</OPTION>
      <OPTION value="Air France">Air   France</OPTION>
      <OPTION value="AirTran Airways">AirTran Airways</OPTION>
      <OPTION value="Alaska Airlines">Alaska Airlines</OPTION>
      <OPTION value="America West Airlines">America West Airlines</OPTION>
      <OPTION value="American Airlines/American Eagle">American Airlines/American   Eagle</OPTION>
      <OPTION value="British Airways">British Airways</OPTION>
      <OPTION value="Canadian Airlines">Canadian Airlines</OPTION>
      <OPTION value="CO">Continental Airlines</OPTION>
      <OPTION value="DL">Delta Air Lines</OPTION>
      <OPTION value="HA">Hawaiian Airlines</OPTION>
      <OPTION value="IB">Iberia</OPTION>
      <OPTION value="FI">Icelandair</OPTION>
      <OPTION value="Independence Air">Independence Air</OPTION>
      <OPTION value="Jet Blue">Jet   Blue</OPTION>
      <OPTION value="LC">Legend Airlines</OPTION>
      <OPTION value="Lufthansa">Lufthansa</OPTION>
      <OPTION value="Midway Airlines">Midway   Airlines</OPTION>
      <OPTION value="Midwest Express">Midwest Express</OPTION>
      <OPTION value="Northwest Airlines">Northwest Airlines</OPTION>
      <OPTION value="QF">Qantas Airlines</OPTION>
      <OPTION value="Southwest">Southwest</OPTION>
      <OPTION value="TWA - Trans World Airlines">TWA - Trans World Airlines</OPTION>
      <OPTION value="United Airlines">United Airlines</OPTION>
      <OPTION value="US Airways">US Airways</OPTION>
      <OPTION value="Virgin Atlantic">Virgin   Atlantic</OPTION>
    </SELECT></TD>
  </TR>
  <TR>
    <TD width="246">Flight #:</TD>
    <TD width="394"><INPUT size="10" name="PickupFlightNum" value=""></TD>
  </TR>
  <TR>
    <TD width="246">Arrival Time:</TD>
    <TD width="394"><SELECT onchange="CF_TIMEINPUT_ChangeTime (this.form, 'PickupArrivalTime');" name="PickupArrivalTime_hour">
      <OPTION value="0" selected>12</OPTION>
      <OPTION value="1">1</OPTION>
      <OPTION value="2">2</OPTION>
      <OPTION value="3">3</OPTION>
      <OPTION value="4">4</OPTION>
      <OPTION value="5">5</OPTION>
      <OPTION value="6">6</OPTION>
      <OPTION value="7">7</OPTION>
      <OPTION value="8">8</OPTION>
      <OPTION value="9">9</OPTION>
      <OPTION value="10">10</OPTION>
      <OPTION value="11">11</OPTION>
    </SELECT>
      :
      <SELECT onchange="CF_TIMEINPUT_ChangeTime (this.form, 'PickupArrivalTime');" name="PickupArrivalTime_minute">
        <OPTION value="0" selected>00</OPTION>
        <OPTION value="1">01</OPTION>
        <OPTION value="2">02</OPTION>
        <OPTION value="3">03</OPTION>
        <OPTION value="4">04</OPTION>
        <OPTION value="5">05</OPTION>
        <OPTION value="6">06</OPTION>
        <OPTION value="7">07</OPTION>
        <OPTION value="8">08</OPTION>
        <OPTION value="9">09</OPTION>
        <OPTION value="10">10</OPTION>
        <OPTION value="11">11</OPTION>
        <OPTION value="12">12</OPTION>
        <OPTION value="13">13</OPTION>
        <OPTION value="14">14</OPTION>
        <OPTION value="15">15</OPTION>
        <OPTION value="16">16</OPTION>
        <OPTION value="17">17</OPTION>
        <OPTION value="18">18</OPTION>
        <OPTION value="19">19</OPTION>
        <OPTION value="20">20</OPTION>
        <OPTION value="21">21</OPTION>
        <OPTION value="22">22</OPTION>
        <OPTION value="23">23</OPTION>
        <OPTION value="24">24</OPTION>
        <OPTION value="25">25</OPTION>
        <OPTION value="26">26</OPTION>
        <OPTION value="27">27</OPTION>
        <OPTION value="28">28</OPTION>
        <OPTION value="29">29</OPTION>
        <OPTION value="30">30</OPTION>
        <OPTION value="31">31</OPTION>
        <OPTION value="32">32</OPTION>
        <OPTION value="33">33</OPTION>
        <OPTION value="34">34</OPTION>
        <OPTION value="35">35</OPTION>
        <OPTION value="36">36</OPTION>
        <OPTION value="37">37</OPTION>
        <OPTION value="38">38</OPTION>
        <OPTION value="39">39</OPTION>
        <OPTION value="40">40</OPTION>
        <OPTION value="41">41</OPTION>
        <OPTION value="42">42</OPTION>
        <OPTION value="43">43</OPTION>
        <OPTION value="44">44</OPTION>
        <OPTION value="45">45</OPTION>
        <OPTION value="46">46</OPTION>
        <OPTION value="47">47</OPTION>
        <OPTION value="48">48</OPTION>
        <OPTION value="49">49</OPTION>
        <OPTION value="50">50</OPTION>
        <OPTION value="51">51</OPTION>
        <OPTION value="52">52</OPTION>
        <OPTION value="53">53</OPTION>
        <OPTION value="54">54</OPTION>
        <OPTION value="55">55</OPTION>
        <OPTION value="56">56</OPTION>
        <OPTION value="57">57</OPTION>
        <OPTION value="58">58</OPTION>
        <OPTION value="59">59</OPTION>
      </SELECT>
      <SELECT onchange="CF_TIMEINPUT_ChangeTime (this.form, 'PickupArrivalTime');" size="1" name="PickupArrivalTime_period">
        <OPTION value="AM">am</OPTION>
        <OPTION value="PM" selected>pm</OPTION>
      </SELECT>
    </TD>
  </TR>
  <TR>
    <TD colSpan="2"> </TD>
  </TR>
  <TR>
    <TD bgColor="#E8E8E8" colSpan="2" height="21"><strong>Drop Off Information</strong></TD>
  </TR>
  <!--<TR>
    <TD width="246">Select One:</TD>
    <TD width="394"> </TD>
  </TR>-->
  <TR>
    <TD colSpan="2"><em><strong>Address</strong></em></TD>
  </TR>
  <TR>
    <TD width="246">Address:</TD>
    <TD width="394"><INPUT size="57" name="DropoffAddress" value=""></TD>
  </TR>
  <TR>
    <TD width="246">City<SPAN lang="en-us">,</SPAN>State<SPAN lang="en-us">,Zip</SPAN>:</TD>
    <TD width="394"><INPUT size="26" name="DropoffCity">
        <SELECT size="1" name="DropoffState">
          <OPTION value="AK">AK</OPTION>
          <OPTION value="AL">AL</OPTION>
          <OPTION value="AR">AR</OPTION>
          <OPTION value="AZ">AZ</OPTION>
          <OPTION value="CA">CA</OPTION>
          <OPTION value="CO">CO</OPTION>
          <OPTION value="CT">CT</OPTION>
          <OPTION value="DC">DC</OPTION>
          <OPTION value="DE">DE</OPTION>
          <OPTION value="FL">FL</OPTION>
          <OPTION value="GA">GA</OPTION>
          <OPTION value="HI">HI</OPTION>
          <OPTION value="IA">IA</OPTION>
          <OPTION value="ID">ID</OPTION>
          <OPTION value="IL">IL</OPTION>
          <OPTION value="IN">IN</OPTION>
          <OPTION value="KS">KS</OPTION>
          <OPTION value="KY">KY</OPTION>
          <OPTION value="LA">LA</OPTION>
          <OPTION value="MA">MA</OPTION>
          <OPTION value="MD">MD</OPTION>
          <OPTION value="ME">ME</OPTION>
          <OPTION value="MI">MI</OPTION>
          <OPTION value="MN">MN</OPTION>
          <OPTION value="MO">MO</OPTION>
          <OPTION value="MS">MS</OPTION>
          <OPTION value="MT">MT</OPTION>
          <OPTION value="NC">NC</OPTION>
          <OPTION value="ND">ND</OPTION>
          <OPTION value="NE">NE</OPTION>
          <OPTION value="NH">NH</OPTION>
          <OPTION value="NJ">NJ</OPTION>
          <OPTION value="NM">NM</OPTION>
          <OPTION value="NV">NV</OPTION>
          <OPTION value="NY">NY</OPTION>
          <OPTION value="OH">OH</OPTION>
          <OPTION value="OK">OK</OPTION>
          <OPTION value="OR">OR</OPTION>
          <OPTION value="PA">PA</OPTION>
          <OPTION value="RI">RI</OPTION>
          <OPTION value="SC">SC</OPTION>
          <OPTION value="SD">SD</OPTION>
          <OPTION value="TN">TN</OPTION>
          <OPTION value="TX">TX</OPTION>
          <OPTION value="UT">UT</OPTION>
          <OPTION value="VA" selected>VA</OPTION>
          <OPTION value="VT">VT</OPTION>
          <OPTION value="WA">WA</OPTION>
          <OPTION value="WI">WI</OPTION>
          <OPTION value="WV">WV</OPTION>
          <OPTION value="WY">WY</OPTION>
        </SELECT>
        <INPUT size="15" name="Dropoffzip" value=""></TD>
  </TR>
  <TR>
    <TD colSpan="2"><em><strong>Airport</strong></em></TD>
  </TR>
  <TR>
    <TD width="246">Airport Name:</TD>
    <TD width="394"><INPUT size="54" name="DropoffAirport" value=""></TD>
  </TR>
  <TR>
    <TD width="246">Airline:</TD>
    <TD width="394"><SELECT name="DropoffAirline">
      <OPTION value="Air Canada" selected>Air Canada</OPTION>
      <OPTION value="Air France">Air   France</OPTION>
      <OPTION value="AirTran Airways">AirTran Airways</OPTION>
      <OPTION value="Alaska Airlines">Alaska Airlines</OPTION>
      <OPTION value="America West Airlines">America West Airlines</OPTION>
      <OPTION value="American Airlines/American Eagle">American Airlines/American   Eagle</OPTION>
      <OPTION value="British Airways">British Airways</OPTION>
      <OPTION value="Canadian Airlines">Canadian Airlines</OPTION>
      <OPTION value="CO">Continental Airlines</OPTION>
      <OPTION value="DL">Delta Air Lines</OPTION>
      <OPTION value="HA">Hawaiian Airlines</OPTION>
      <OPTION value="IB">Iberia</OPTION>
      <OPTION value="FI">Icelandair</OPTION>
      <OPTION value="LC">Legend Airlines</OPTION>
      <OPTION value="Lufthansa">Lufthansa</OPTION>
      <OPTION value="Midway Airlines">Midway Airlines</OPTION>
      <OPTION value="Midwest Express">Midwest Express</OPTION>
      <OPTION value="Northwest Airlines">Northwest Airlines</OPTION>
      <OPTION value="QF">Qantas   Airlines</OPTION>
      <OPTION value="Southwest">Southwest</OPTION>
      <OPTION value="TWA - Trans World Airlines">TWA - Trans World Airlines</OPTION>
      <OPTION value="United Airlines">United Airlines</OPTION>
      <OPTION value="US Airways">US   Airways</OPTION>
      <OPTION value="Virgin Atlantic">Virgin   Atlantic</OPTION>
    </SELECT></TD>
  </TR>
  <TR>
    <TD width="246">Departure Time:</TD>
    <TD width="394"><SELECT onchange="CF_TIMEINPUT_ChangeTime (this.form, 'DropoffDepartureTime');" name="DropoffDepartureTime_hour">
      <OPTION value="0" selected>12</OPTION>
      <OPTION value="1">1</OPTION>
      <OPTION value="2">2</OPTION>
      <OPTION value="3">3</OPTION>
      <OPTION value="4">4</OPTION>
      <OPTION value="5">5</OPTION>
      <OPTION value="6">6</OPTION>
      <OPTION value="7">7</OPTION>
      <OPTION value="8">8</OPTION>
      <OPTION value="9">9</OPTION>
      <OPTION value="10">10</OPTION>
      <OPTION value="11">11</OPTION>
    </SELECT>
      :
      <SELECT onchange="CF_TIMEINPUT_ChangeTime (this.form, 'DropoffDepartureTime');" name="DropoffDepartureTime_minute">
        <OPTION value="0" selected>00</OPTION>
        <OPTION value="1">01</OPTION>
        <OPTION value="2">02</OPTION>
        <OPTION value="3">03</OPTION>
        <OPTION value="4">04</OPTION>
        <OPTION value="5">05</OPTION>
        <OPTION value="6">06</OPTION>
        <OPTION value="7">07</OPTION>
        <OPTION value="8">08</OPTION>
        <OPTION value="9">09</OPTION>
        <OPTION value="10">10</OPTION>
        <OPTION value="11">11</OPTION>
        <OPTION value="12">12</OPTION>
        <OPTION value="13">13</OPTION>
        <OPTION value="14">14</OPTION>
        <OPTION value="15">15</OPTION>
        <OPTION value="16">16</OPTION>
        <OPTION value="17">17</OPTION>
        <OPTION value="18">18</OPTION>
        <OPTION value="19">19</OPTION>
        <OPTION value="20">20</OPTION>
        <OPTION value="21">21</OPTION>
        <OPTION value="22">22</OPTION>
        <OPTION value="23">23</OPTION>
        <OPTION value="24">24</OPTION>
        <OPTION value="25">25</OPTION>
        <OPTION value="26">26</OPTION>
        <OPTION value="27">27</OPTION>
        <OPTION value="28">28</OPTION>
        <OPTION value="29">29</OPTION>
        <OPTION value="30">30</OPTION>
        <OPTION value="31">31</OPTION>
        <OPTION value="32">32</OPTION>
        <OPTION value="33">33</OPTION>
        <OPTION value="34">34</OPTION>
        <OPTION value="35">35</OPTION>
        <OPTION value="36">36</OPTION>
        <OPTION value="37">37</OPTION>
        <OPTION value="38">38</OPTION>
        <OPTION value="39">39</OPTION>
        <OPTION value="40">40</OPTION>
        <OPTION value="41">41</OPTION>
        <OPTION value="42">42</OPTION>
        <OPTION value="43">43</OPTION>
        <OPTION value="44">44</OPTION>
        <OPTION value="45">45</OPTION>
        <OPTION value="46">46</OPTION>
        <OPTION value="47">47</OPTION>
        <OPTION value="48">48</OPTION>
        <OPTION value="49">49</OPTION>
        <OPTION value="50">50</OPTION>
        <OPTION value="51">51</OPTION>
        <OPTION value="52">52</OPTION>
        <OPTION value="53">53</OPTION>
        <OPTION value="54">54</OPTION>
        <OPTION value="55">55</OPTION>
        <OPTION value="56">56</OPTION>
        <OPTION value="57">57</OPTION>
        <OPTION value="58">58</OPTION>
        <OPTION value="59">59</OPTION>
      </SELECT>
      <SELECT onchange="CF_TIMEINPUT_ChangeTime (this.form, 'DropoffDepartureTime');" size="1" name="DropoffDepartureTime_period">
        <OPTION value="AM">am</OPTION>
        <OPTION value="PM" selected>pm</OPTION>
      </SELECT>
    </TD>
  </TR>
  <TR>
    <TD colSpan="2"> </TD>
  </TR>
  <TR>
    <TD bgColor="#E8E8E8" colSpan="2" height="21"><strong>Billing Information</strong></TD>
  </TR>
  <TR>
    <TD width="246">Name:</TD>
    <TD width="394"><INPUT size="30" name="BillingName" value=""></TD>
  </TR>
  <TR>
    <TD width="246"><SPAN lang="en-us">CC Billing   Address</SPAN>:</TD>
    <TD width="394"><INPUT size="56" name="BillingCompany" value=""></TD>
  </TR>
  <TR>
    <TD width="246">Payment Method:</TD>
    <TD width="394"><SELECT name="BillingType">
      <OPTION value="Visa" selected>Visa</OPTION>
      <OPTION value="MasterCard">MasterCard</OPTION>
      <OPTION value="American Express">American Express</OPTION>
      <OPTION value="Other">Other</OPTION>
      <OPTION value="Account">Account</OPTION>
    </SELECT></TD>
  </TR>
  <TR>
    <TD width="246">Card #:</TD>
    <TD width="394"><INPUT size="55" name="BillingCardNum" value=""></TD>
  </TR>
  <TR>
    <TD width="246">Exp. Date:</TD>
    <TD width="394"><INPUT size="7" name="BillingExpDate" value="">
       
      mm/yyyy</TD>
  </TR>
  <TR>
    <TD colSpan="2"> </TD>
  </TR>
  <TR>
    <TD bgColor="#E8E8E8" colSpan="2" height="21"><strong>Contact Information</strong></TD>
  </TR>
  <TR>
    <TD width="246">Name:</TD>
    <TD width="394"><INPUT size="58" name="ContactName" value=""></TD>
  </TR>
  <TR>
    <TD colSpan="2"> </TD>
  </TR>
  <TR>
    <TD bgColor="#E8E8E8" colSpan="2" height="21"><strong>Enter Any Comments Below</strong></TD>
  </TR>
  <TR>
    <TD colSpan="2"><p align="center">
      <TEXTAREA name="Comments1" rows="5" cols="61"></TEXTAREA>
    </p></TD>
  </TR>
  <TR>
    <TD width="246"> </TD>
    <TD width="394"> </TD>
  </TR>
  <TR>
    <TD colSpan="2"><DIV align="center">
      <INPUT type="submit" value="Send" name="submit">
    </DIV></TD>
  </TR>
</table>
</form>

 </td>
                </tr>
                <tr>
                  <td valign="top">&nbsp;</td>
                  <td class="light">----------------------------------------------------------------------------------------------------------------------------</td>
                </tr>
                <tr>
                  <td valign="top">&nbsp;</td>
                  <td>&nbsp;</td>
                </tr>
            </table></td>
            <td width="1%"><img src="images/spacer.gif" width="10" height="1" /></td>
            <td width="30%" valign="top"><table width="75%" border="0" cellpadding="0" cellspacing="0">
                <tr>
                  <td><img src="images/001.gif" width="222" height="37" /></td>
                </tr>
                <tr>
                  <td><img src="images/002.gif" width="222" height="113" /></td>
                </tr>
                <tr>
                  <td class="text1"> Dummy copy Madison Limousine Services Inc. offers Special Packages tailored to your corporate events and personal occasions.Madison Limousine Services Inc.  offers Special Packages.</td>
                </tr>
                <tr>
                  <td><img src="images/reservations.jpg" width="222" height="34" alt="Reservation"/></td>
                </tr>
                <tr>
                  <td>&nbsp;</td>
                </tr>
            </table></td>
          </tr>
        </table></td>
      </tr>
    </table></td>
    <td background="images/bg-shadow2.gif">&nbsp;</td>
  </tr>
  <tr>
    <td><img id="b1" src="images/b1.gif" width="7" height="45" alt="" /></td>
    <td align="center" background="images/bg-bot-links.gif" bgcolor="#fefefd" class="blinks"><a href="index.html" style="color:#000000">Home</a>  &nbsp; &nbsp;&nbsp;|&nbsp; &nbsp;  &nbsp;<a href="sitemap.html"style="color:#000000">Site Map</a>  &nbsp; &nbsp;&nbsp;|&nbsp; &nbsp;&nbsp; <a href="contactus.html"style="color:#000000">Contact</a></td>
    <td><img src="images/b2.gif" width="7" height="45" alt="" /></td>
 
  <tr>
    <td>&nbsp;</td>
    <td align="center" bgcolor="#fefefd" class="light">Copyright &copy; 2008 Madison Limousine Service Inc. All Rights Reserved. <br /></td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td>&nbsp;</td>
    <td align="center" bgcolor="#fefefd" style="padding-top:5px; padding-bottom:5px;" class="light">Site Designed by<a href="http://www.usawebfx.com" target="_blank" style="color:#999999;"> Webfx</a> </td>
    <td>&nbsp;</td>
  </tr>
</table>
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