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<table cellspacing="0" cellpadding="4" border="0">
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<td align="right"><label for="name">Name:</label></td>
<td><input type="text" name="cm-name" id="name" size="20" /></td>
</tr>
<tr valign="top">
<td align="right"><label for="fqykd-fqykd">Email address:</label></td>
<td><input type="text" name="cm-fqykd-fqykd" id="fqykd-fqykd" size="20" /></td>
</tr>
<tr>
  <td align="right" valign="top"><label for="Reason you golf?">Reason you golf?:</label></td>
  <td><input type="radio" name="cm-fo-ctlhyk" id="cm2590925" value="2590925" /> <label for="cm2590925">It's my career</label><br />
<input type="radio" name="cm-fo-ctlhyk" id="cm2590927" value="2590927" /> <label for="cm2590927">I plan to make it my career</label><br />
<input type="radio" name="cm-fo-ctlhyk" id="cm2590926" value="2590926" /> <label for="cm2590926">Cause it's fun</label><br />
<input type="radio" name="cm-fo-ctlhyk" id="cm2590928" value="2590928" /> <label for="cm2590928">Other-</label></td>
</tr>
<tr>
  <td align="right" valign="top"><label for="Location">Location:</label></td>
  <td><select name="cm-fo-ctlkkl">
<option value="2591027">Australia</option>
<option value="2591029">New Zealand</option>
<option value="2591028">Asia</option>
<option value="2591031">United States</option>
<option value="2966231">Europe</option>
<option value="2591030">United Kingdom</option>
<option value="2591032">South Africa</option>
<option value="2591033">Other</option>
</select></td>
</tr>
<tr>
  <td align="right"><label for="How long have you golfed?">How long have you golfed?:</label></td>
  <td><input type="text" name="cm-f-ctlkkr" id="Howlonghaveyougolfed?" size="20" /></td>
</tr>
<tr>
  <td align="right"><label for="Years you have golfed">Years you have golfed:</label></td>
  <td><input type="text" name="cm-f-fuyjhd" id="Yearsyouhavegolfed" size="20" /></td>
</tr>
<tr valign="top">
<td></td>
<td><input type="submit" value="Subscribe" /></td>
</tr>
</table>
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