<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<HTML>
<HEAD>
<META NAME="Generator" CONTENT="Reality">
<TITLE>Name and Address Details</TITLE>
</HEAD>
<BODY>
<FORM ACTION="FORMHF2A" NAME="NAMEFORM" METHOD="POST">
Enter your name and address, then click Submit to continue
<BR>
<BR>
<FIELDSET>
Name: <INPUT NAME="NAME" SIZE="30" TYPE="TEXT">
<BR>
Address: <INPUT NAME="ADD1" SIZE="30" TYPE="TEXT">
<BR>
<INPUT NAME="ADD2" SIZE="30" TYPE="TEXT">
<BR>
<INPUT NAME="ADD3" SIZE="30" TYPE="TEXT">
<BR>
Postcode: <INPUT NAME="PCODE" SIZE="7" TYPE="TEXT">
<BR>
<BR>
</FIELDSET>
<INPUT TYPE="submit" VALUE="Submit">
</FORM>
</BODY>
</HTML>