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<HTML>
<HEAD>


<META NAME="description" CONTENT="My Favorite Mechanic is a Woman! shop,garage, auto,consultant,writer,speaker,entrepreneur,newcar,used car, maintenance,help,advice. In her RV & in the news. ">
<META NAME="Keywords"    CONTENT="car,cars,woman,business opportunities,franchise,new car,used car,writer,consultant,news,speaker,my favorite,RV,auto,shop,entrepreneur,maintenance,garage,car care,car repair,seminar"> 


<!-- business -->


<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=ISO-8859-1">
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<!--<BASE HREF="http://myfavoritemechanic.com/form.html.html">-->
<TITLE>SHOP START INFORMATION REQUEST</TITLE></head>
<BODY  BGCOLOR="#FFFFFF"
 TEXT="#000000"

MARGINHEIGHT="0" MARGINWIDTH="0" LEFTMARGIN="0" TOPMARGIN="0" RIGHTMARGIN="0" BOTTOMMARGIN="0"

 onLoad=""
 LINK="#0000FF"
 VLINK="#FF00CC"
 ALINK="#FF00CC"
>

  
      <!-- BOF: ./personal-templates/simple/business/layout/l23.layout --> 


<table width="100%" border="0" cellpadding="0" cellspacing="0">
	<tr>
		<td>
			<img src="widgets/gen_10.1.gif" width="88" height="92"></td>
		<td width="100%" background="widgets/gen_15.1.gif">
			<img src="widgets/gen_275.1.gif" width="498" height="92"></td>
		<td>
			<img src="widgets/gen_14.1.gif" width="164" height="92"></td>
	</tr>
	<tr>
		<td valign="top" background="widgets/gen_17.1.gif">
			<img src="widgets/gen_13.1.gif" width="88" height="85"></td>
		<td valign="top">
			<img src="widgets/gen_16.1.gif" width="449" height="47" border="0"><br>
		<!-- BOF: ./personal-templates/simple/businessnew/form/style_l23.html -->


			<table width="90%" border="0" cellpadding="0" cellspacing="0">
				<tr>
					<td background="widgets/gen_2.1.gif">
						<table background="" cellpadding="0" cellspacing="0" border="0" width="100%">
							<tr>
							<td width="50%" valign="top" align="right"><img src="widgets/gen_8.1.gif"></td>
							<td bgcolor="#FFFFFF" nowrap>&nbsp; 


<font face='Arial' size='+1' color='#000000'>

SHOP START INFORMATION REQUEST

</font>


 &nbsp;</td>
							<td width="50%" valign="top" align="left"><img src="widgets/gen_9.1.gif"></td>
							</tr>
						</table>
					</td>
					<td background="widgets/gen_2.1.gif" align="center">
						<img src="widgets/gen_3.1.gif" width="70" height="22"></td>
				</tr>
				<tr>
					<TD VALIGN=top width="100%"><br>


         <SCRIPT LANGUAGE="JavaScript">
function validate(){
	var valid;
        valid=true;
    	var valueExists;


if (document.forms[0].field_73.value==""){ valid=false; };


if (document.forms[0].field_75.value==""){ valid=false; };


if (document.forms[0].field_76.value==""){ valid=false; };


    valueExists = false;
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    {   
	if (document.forms[0].field_78[i].checked) { 
	    valueExists = true;
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    if (valueExists==false) valid=false;


    valueExists = false;
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    {   
	if (document.forms[0].field_79[i].checked) { 
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    if (valueExists==false) valid=false;


if (document.forms[0].field_108.value==""){ valid=false; };


if (document.forms[0].field_80.value==""){ valid=false; };


if (document.forms[0].field_203.value==""){ valid=false; };


if (document.forms[0].field_81.value==""){ valid=false; };


if (document.forms[0].field_82.value==""){ valid=false; };


if (document.forms[0].field_85.value==""){ valid=false; };


if (valid==false) { 
		alert('You did not fill all required fields!'); 
	    }

return valid;
}
</SCRIPT>

 
<!--DO NOT MODIFY THIS FIRST LINE -->
<form method=POST action="http://rocketlist.com/cgi-bin/formmail/formmail.pl">

<!-- MODIFY THIS VALUE: Add a custom reply URL -->
<input type=hidden name="redirect" value="http://www.myfavoritemechanic.com /onsubmit.html">

<!-- MODIFY THIS VALUE: Add your domain-based email here -->
<input type=hidden name="recipient" value="sales@myfavoritemechanic.com">

<!-- MODIFY THIS VALUE Add your custom email subject  -->
<input type=hidden name="subject" value="SHOP START INFORMATION REQUEST!">

<!--Your HTML Form code should go here -->


<TABLE border="0" cellpadding="5" cellspacing="0" width="95%">
<tr>
	<td colspan=2>&nbsp;</td>
</tr>


<input type="hidden" name="name_71" value="Thank you for taking the time to contact My Favorite Mechanic. Your questions are welcome. Your inquiries and the information that you provide below will be very helpful in our initial conversation. BE IN BUSINESS FOR YOURSELF-NOT BY YOURSELF!">
<tr>	
	<td>Thank you for taking the time to contact My Favorite Mechanic. Your questions are welcome. Your inquiries and the information that you provide below will be very helpful in our initial conversation. BE IN BUSINESS FOR YOURSELF-NOT BY YOURSELF!</td>
	<td>


</td>
</tr> 

<input type="hidden" name="name_72" value="Please enter today's date:">
<tr>	
	<td>Please enter today's date:</td>
	<td>


<select name="field_m_72" size="1">
<option>Jan
<option>Feb
<option>Mar
<option>Apr
<option>May
<option>Jun
<option>Jul
<option>Aug
<option>Sep
<option>Oct
<option>Nov
<option>Dec
</select>
<select name="field_d_72" size="1">
<option>1<option>2<option>3<option>4<option>5<option>6<option>7<option>8<option>9<option>10<option>11<option>12<option>13<option>14<option>15<option>16<option>17<option>18<option>19<option>20<option>21<option>22<option>23<option>24<option>25<option>26<option>27<option>28<option>29<option>30<option>31
</select>
<input type="text" name="field_y_72" size="4" maxsize="4">

</td>
</tr> 

<input type="hidden" name="name_73" value="First Name:">
<tr>	
	<td>First Name:<font color="red" size="-1">*</font></td>
	<td>


<input type="text" name="field_73" size="35">


</td>
</tr> 

<input type="hidden" name="name_74" value="Middle Name:">
<tr>	
	<td>Middle Name:</td>
	<td>


<input type="text" name="field_74" size="35">


</td>
</tr> 

<input type="hidden" name="name_75" value="Last Name:">
<tr>	
	<td>Last Name:<font color="red" size="-1">*</font></td>
	<td>


<input type="text" name="field_75" size="35">


</td>
</tr> 

<input type="hidden" name="name_76" value="Complete current address including zip code:">
<tr>	
	<td>Complete current address including zip code:<font color="red" size="-1">*</font></td>
	<td>


<textarea name="field_76" rows="5" cols="30"></textarea>


</td>
</tr> 

<input type="hidden" name="name_77" value="Your Questions and/or Comments">
<tr>	
	<td>Your Questions and/or Comments</td>
	<td>


<textarea name="field_77" rows="5" cols="30"></textarea>


</td>
</tr> 

<input type="hidden" name="name_78" value="I presently own a shop.">
<tr>	
	<td>I presently own a shop.<font color="red" size="-1">*</font></td>
	<td>


 <input type="radio" name="field_78" value="Yes">Yes <input type="radio" name="field_78" value="No">No


</td>
</tr> 

<input type="hidden" name="name_79" value="I am interested in a new shop start-up.">
<tr>	
	<td>I am interested in a new shop start-up.<font color="red" size="-1">*</font></td>
	<td>


 <input type="radio" name="field_79" value="Yes">Yes <input type="radio" name="field_79" value="No">No


</td>
</tr> 

<input type="hidden" name="name_108" value="In what city and state are you planning to open your shop?">
<tr>	
	<td>In what city and state are you planning to open your shop?<font color="red" size="-1">*</font></td>
	<td>


<input type="text" name="field_108" size="35">


</td>
</tr> 

<input type="hidden" name="name_80" value="I am interested in and considering My Favorite Mechanic because:">
<tr>	
	<td>I am interested in and considering My Favorite Mechanic because:<font color="red" size="-1">*</font></td>
	<td>


<textarea name="field_80" rows="5" cols="30"></textarea>


</td>
</tr> 

<input type="hidden" name="name_203" value="In what areas will you need training or assistance from My Favorite Mechanic?  ">
<tr>	
	<td>In what areas will you need training or assistance from My Favorite Mechanic?  <font color="red" size="-1">*</font></td>
	<td>


<textarea name="field_203" rows="5" cols="30"></textarea>


</td>
</tr> 

<input type="hidden" name="name_81" value="My email address is:">
<tr>	
	<td>My email address is:<font color="red" size="-1">*</font></td>
	<td>


<input type="text" name="field_81" size="35">


</td>
</tr> 

<input type="hidden" name="name_82" value="The phone number(s) to reach me:">
<tr>	
	<td>The phone number(s) to reach me:<font color="red" size="-1">*</font></td>
	<td>


<textarea name="field_82" rows="5" cols="30"></textarea>


</td>
</tr> 

<input type="hidden" name="name_83" value="My web site address is:">
<tr>	
	<td>My web site address is:</td>
	<td>


<input type="text" name="field_83" size="35">


</td>
</tr> 

<input type="hidden" name="name_85" value="Funds (liquid capital) available for opening a shop.">
<tr>	
	<td>Funds (liquid capital) available for opening a shop.<font color="red" size="-1">*</font></td>
	<td>


<textarea name="field_85" rows="5" cols="30"></textarea>


</td>
</tr> 

<tr>
	
	<td COLSPAN="2">
	 
	<input type="submit" onClick="return validate()"><input type="reset">
	</td></tr>
</table>

</form>


					</td>
					<td valign="top" align="center">
						<table border="0" cellpadding="0" cellspacing="0">
							<tr>
								<td background="widgets/gen_6.1.gif" align="center"><img src="widgets/gen_4.1.gif" width="70" height="17"></td>
							</tr>
							<tr>
								<td><img src="widgets/gen_192.1.gif"></td>
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							<tr>
								<td valign="top" background="widgets/gen_7.1.gif" align="center"><img src="widgets/gen_5.1.gif" width="70" height="24"></td>
							</tr>
						</table><br><br>
					</td>
				</tr>
			</table>


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			<br>
		</td>
		<td valign="top" background="widgets/gen_18.1.gif">
		<table width="164" border="0" cellpadding="0" cellspacing="0" background="">
			<tr>
				<td valign="bottom">
				<img src="widgets/gen_20.1.gif" border="0" width="164" height="5"></td>
			</tr>
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="index.html" onMouseOver="document.images['img6'].src='widgets/gen_140.1.gif'" onMouseOut="document.images['img6'].src='widgets/gen_141.1.gif'"><img src="widgets/gen_141.1.gif" alt="HOME" name="img6" border="0"></a>
				</td>
			</tr>
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="walk.html" onMouseOver="document.images['img22'].src='widgets/gen_220.1.gif'" onMouseOut="document.images['img22'].src='widgets/gen_221.1.gif'"><img src="widgets/gen_221.1.gif" alt="~SLIDE SHOW~" name="img22" border="0"></a>
				</td>
			</tr>
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="consult.html" onMouseOver="document.images['img179'].src='widgets/gen_222.1.gif'" onMouseOut="document.images['img179'].src='widgets/gen_223.1.gif'"><img src="widgets/gen_223.1.gif" alt="CONSULTANT" name="img179" border="0"></a>
				</td>
			</tr>
			
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="speak.html" onMouseOver="document.images['img123'].src='widgets/gen_244.1.gif'" onMouseOut="document.images['img123'].src='widgets/gen_245.1.gif'"><img src="widgets/gen_245.1.gif" alt="SPEAKER / EDUCATOR" name="img123" border="0"></a>
				</td>
			</tr>
			
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="write.html" onMouseOver="document.images['img140'].src='widgets/gen_246.1.gif'" onMouseOut="document.images['img140'].src='widgets/gen_247.1.gif'"><img src="widgets/gen_247.1.gif" alt="FREELANCE WRITER" name="img140" border="0"></a>
				</td>
			</tr>
			
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="about.html" onMouseOver="document.images['img7'].src='widgets/gen_234.1.gif'" onMouseOut="document.images['img7'].src='widgets/gen_235.1.gif'"><img src="widgets/gen_235.1.gif" alt="ABOUT THE FOUNDER" name="img7" border="0"></a>
				</td>
			</tr>
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="resume1.html" onMouseOver="document.images['img28'].src='widgets/gen_149.1.gif'" onMouseOut="document.images['img28'].src='widgets/gen_150.1.gif'"><img src="widgets/gen_150.1.gif" alt="RESUME" name="img28" border="0"></a>
				</td>
			</tr>
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="testimonial.html" onMouseOver="document.images['img109'].src='widgets/gen_201.1.gif'" onMouseOut="document.images['img109'].src='widgets/gen_202.1.gif'"><img src="widgets/gen_202.1.gif" alt="TESTIMONIALS" name="img109" border="0"></a>
				</td>
			</tr>
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="tshirt.html" onMouseOver="document.images['img45'].src='widgets/gen_188.1.gif'" onMouseOut="document.images['img45'].src='widgets/gen_189.1.gif'"><img src="widgets/gen_189.1.gif" alt="BUY A T-SHIRT" name="img45" border="0"></a>
				</td>
			</tr>
			
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="giftcert.html" onMouseOver="document.images['img115'].src='widgets/gen_206.1.gif'" onMouseOut="document.images['img115'].src='widgets/gen_207.1.gif'"><img src="widgets/gen_207.1.gif" alt="GIFT CERTIFICATES" name="img115" border="0"></a>
				</td>
			</tr>
			
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="external.html" onMouseOver="document.images['img251'].src='widgets/gen_270.1.gif'" onMouseOut="document.images['img251'].src='widgets/gen_271.1.gif'"><img src="widgets/gen_271.1.gif" alt="MOROTIST FORUM" name="img251" border="0"></a>
				</td>
			</tr>
			
			
			<tr bgcolor="#FFFFFF">
				<td>
				<a href="mailto:INFO@MYFAVORITEMECHANIC.COM" onMouseOver="document.images['img_email'].src='widgets/gen_23.1.gif'" onMouseOut="document.images['img_email'].src='widgets/gen_24.1.gif'"><img src="widgets/gen_24.1.gif" alt="Email Me" name="img_email" border="0"></a></td>
			</tr>
							
			<tr>
				<td valign="top">
					<img src="widgets/gen_12.1.gif" width="164" height="130"></td>
			</tr>
		</table>
		</td>
	</tr>
	<tr>
		<td colspan="3" background="widgets/gen_19.1.gif">
			<img src="widgets/spacer.gif" width="1" height="1"></td>
	</tr>
	<tr>
		<td align="center" colspan="3" valign="top">
			
<br>
<FONT FACE="verdana, arial, helvetica" SIZE="1">
<center>
<nobr>|<a href="index.html">HOME</A>|</nobr>

<nobr>|<a href="walk.html">~SLIDE SHOW~</A>|</nobr>

<nobr>|<a href="consult.html">CONSULTANT</A>|</nobr>

<nobr>|<a href="speak.html">SPEAKER / EDUCATOR</A>|</nobr>

<nobr>|<a href="write.html">FREELANCE WRITER</A>|</nobr>

<nobr>|<a href="about.html">ABOUT THE FOUNDER</A>|</nobr>

<nobr>|<a href="resume1.html">RESUME</A>|</nobr>

<nobr>|<a href="testimonial.html">TESTIMONIALS</A>|</nobr>

<nobr>|<a href="tshirt.html">BUY A T-SHIRT</A>|</nobr>

<nobr>|<a href="giftcert.html">GIFT CERTIFICATES</A>|</nobr>

<nobr>|<a href="external.html">MOROTIST FORUM</A>|</nobr>
</center>
</font>
<BR>
			
<center><table border="0" cellpadding="0" cellspacing="3"><tr><td align="center">

<a href="http://www.psoft.net" target="_blank"><img src="widgets/ss_button.gif" border="0"></a>

<br><font face="helvetica,verdana, arial" size="1"><font face="helvetica,verdana, arial" size="-2">Hosting by One <a href="http://www.onewebhosting.com">Web Hosting</a></font></font>

</td></tr></table></center>
</td>
	</tr>
		
</table>


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</body>
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</html>
   

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