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<HTML>

<HEAD>
<TITLE>Feedback Form</TITLE>
<STYLE>
body{background-image:"environmental.jpg";background-repeat:no-repeat; background.
position:center; height:100%;background-size:100%}
TABLE{background-repeat:no-repeat}
TR{background-repeat:no-repeat;background-position:right}
TD{padding-left:10px}
A:link{color:yellow; display:inline-block; text-decoration:none}
A:visited{color:white}
A:hover{background-color:red}
</STYLE></HEAD><BODY><TABLE width ="100%" height=3 bgcolor="black">
<TR><TD width="20%" height=5 valign="baseline">
<FONT Face="Arial" color="White" size=3>
<P Align="right"><IMG Src="phone.png" align="bottom">&nbsp 81300100096</P>
</TD><TD width="60%" height=5 valign="baseline">
<FONT Face="Arial" color="White" size=2>
<P Align="right"><AHref="https://www.facebook.com"><|MG Src="facebook.png"
align="bottom">
</P></TD><TD width ="20%" height=5 valign="baseline">
<Font Face="Arial" size=2>
<P Align="left"><AHref="https://www.gmail.com"><IMG
Src="gmail.png"align="bottom"></P>
</TD></FONT></TR></TABLE><BR>
<TABLE width = 100% height=35 bgcolor="black">
<TR><TD width ="20%" height=5 valign="baseline">
<FONT Face="Arial" color="White" size=3>
<P Align="left"><|MG Src="top-logo.png" align="bottom"></P>
</TD><TD width = 100% height=35 valign = "middle">
<FONT Face = "Arial" color= "White" size=3>
<P Align="center"> <A Href="main.html"> Home</A>&nbsp |About Us &nbsp| &nbsp<A Href
=
"Airp.html">Air Pollution </A>&nbsp| &nbsp<A Href="Water.html">Water Pollution
</A>&nbsp|
&nbsp<AHref="Soil.htm|">Soil Pollution</A>&nbsp|
&nbsp Suggestions</Font></TD></TR>
</TABLE><FONT Face="Comic Sans MS" size=5 color="green">
<CENTER><H3 Style="background-color:White; width:50%">Please glve your
valuablesuggestions</H3></CENTER><FORM Method="Post"Action="mailto:Info@bhing.com">
<CENTER><TABLE bgcolor=green><TR>
<TD width=60%valign="middle"><FONT Face="Comic Sans MS"size=4 color="yellow">
Name:&nbsp;&nbsp;<inputtype="text"name="First Name"slze=25><BR>
H.no:&nbsp;&nbsp;&nbsp;&nbsp;<INPUT Type="text" size=10>
Street Name/City:&nbsp;&nbsp;<INPUT Type="text"size=25><BR>
State:&nbsp;&nbsp;<INPUT Type="text"size=20><BR>
Phone:&nbsp;&nbsp;<INPUT Type="text"name="Phone"size=25>
E-Mail :<INPUT Type="text" name="E-Mail" size=25><BR><BR><BR>
<FONT Face="Comic Sans MS" size=4 color="yellow">Gender:&nbsp<INPUT type=
"radio",name="sex" value="male">Male
<INPUT Type="radio" name="sex" value="female">Female<BR><BR>
Occupation:&nbsp;&nbsp;&nbsp;<SELECT name="occupation">
<OPTION Value="School Student" Selected>School Student</OPTION>
<OPTION Value="College Student">College Student</OPTION>
<OPTION Value="Professional">Professional</OPTION>
<OPTION Value="Other">Other</OPTION>
</SELECT><BR><BR>Pollution type:<BR><INPUT Type= "radio" name="type"
value="Air">Air Pollution
<INPUT Type="radio" name="type" value="Water">Water Pollution
<INPUT Type="radio" name="type" value="Soil">Soil Pollution
<INPUT Type="radio" name="type" value="Other">Other<BR><BR>
Preventive Measures:<BR>
<TEXTAREA NAME="measures"COLS=30 ROWS=5></TEXTAREA><BR><BR>
<CENTER><FONT Face="Comic Sans MS" size=4 color="yellow"><INPUT Type="submit"
value="Post
your suggestions" Style="font-weight:bolder; font-size:15px; color:red; background-
color:white">
</FORM><TD width=40%>
<IMG Src="Suggestion_box.png">
</TD></TABLE>
</BODY></HTML>

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