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<h3>Write your Discussion</h3>

<form action="sign.php" method="post">

<table border="2" cellpadding="15" cellspacing="10">

	<tr>

		<td valign="top">

		<strong>Name</strong>:<br />

		<input maxlength="35" name="name" size="50" type="text" /><br /><br />

		<strong>Email Address</strong>:<br />

		<input maxlength="125" name="email" size="50" type="text" /><br /><br />

		<strong>Message</strong>:<br />

		<textarea cols="37" name="message" rows="5"></textarea>

		</td>



		<td valign="top">

		<strong>Verification Code</strong>:<br />

		<img alt="" src="captcha.php" title="" /><br /><br />

		<strong>Repeat Verification Code <span style="background: #fff; color: #f00">(Required)</span></strong>:<br />

		(Five characters, case sensitive)<br />

		<input maxlength="5" name="verification" size="5" type="text" /><input name="check" style="visibility: hidden" type="checkbox" value="1" /><br /><br />

		<input type="submit" value="Post Discussion" /><br /><br />

		<hr />

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		</td>

	</tr>

</table>

</form>