Comments and Feedback
From Faculty of Medicine Online Museum and Archive
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| - | + | This site is in development and we welcome your feedback and contributions. Enquiries can also be directed to the managing curator [http://www.usyd.edu.au/perl-bin/phlookup.cgi?type=people&name=Lise+Mellor&Submit+Query.x=0&Submit+Query.y=0&title=&position=&department=&phone= '''Dr Lise Mellor''']. | |
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| + | <html> | ||
| + | <div><form name="alumnifeedback" method="post" action="../../feedback_dbform.php"> | ||
| + | <input type="hidden" name ="db_enqtype" value ="feedback"> | ||
| + | <table><tr> | ||
| + | <td valign="top"><div align="right">First name</div></td> | ||
| + | <td><input type="text" name="db_firstname" value="" tabindex="1" ></td> | ||
| + | |||
| + | </tr> | ||
| + | <tr> | ||
| + | <td valign="top"><div align="right">Surname</div></td> | ||
| + | <td><input type="text" name="db_surname" value="" tabindex="2"></td> | ||
| + | </tr> | ||
| + | <tr> | ||
| + | <td valign="top"><div align="right">Email </div></td> | ||
| + | <td><input type="text" name="db_email" tabindex="3"></td> | ||
| + | </tr> | ||
| + | |||
| + | <tr> | ||
| + | <td valign="top"><div align="right">Phone</div></td> | ||
| + | <td><input type="text" name="db_phone" tabindex="6"></td> | ||
| + | </tr> | ||
| + | <tr> | ||
| + | <td valign="top"><div align="right">Comment</div></td> | ||
| + | <td><textarea name="db_comment" cols="60" rows="5" tabindex="10"></textarea></td> | ||
| + | |||
| + | </tr> | ||
| + | <tr> | ||
| + | <td valign="top"></td> | ||
| + | <td><input type="submit" name="Submit" value="Submit" tabindex="100"></td> | ||
| + | </tr> | ||
| + | </table> | ||
| + | </form></div> | ||
| + | </html> | ||
Current revision as of 05:03, 10 December 2009
This site is in development and we welcome your feedback and contributions. Enquiries can also be directed to the managing curator Dr Lise Mellor.