<!-- BOF: ./personal-templates/show.body -->
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<!-- Locale=en_US_ISO8859_1 -->
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<!-- BOF: ./personal-templates/simple/generic/navbar --><!-- EOF: ./personal-templates/simple/generic/navbar -->


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<!-- EOF: ./personal-templates/simple/generic/show -->

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<!-- BOF: ./personal-templates/simple/personal/other/l27.settings.init -->

  
<!-- EOF: ./personal-templates/simple/personal/other/l27.settings.init -->


  <!-- BOF: ./personal-templates/simple/business/layout/l27.wait -->


<!-- EOF: ./personal-templates/simple/business/layout/l27.wait -->


<HTML>

<HEAD>


<META NAME="description" CONTENT="Window and Door Repairs up and down the entire East Coast. Professionalism at its best. JAJ CONSTRUCTION">
<META NAME="Keywords"    CONTENT="Window, Door, JELD-WIN, jaj, repair, installation, pozzi, home depot, sash, clad, casement, double hung, screens">


<!-- business -->


<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=UTF-8">
<META NAME="Generator" content="">
<!-- BOF: ./personal-templates/simple/themes.show -->


<!-- EOF: ./personal-templates/simple/themes.show -->


<!--<BASE HREF="http://71.18.130.152/form.html">-->
<TITLE>Appointment</TITLE></head>
<BODY  BGCOLOR="#19130F"
 TEXT="#FFFFFF"

LEFTMARGIN="0" TOPMARGIN="0" RIGHTMARGIN="0" BOTTOMMARGIN="0"

 onLoad=""
 
 LINK="#FFFFFF"
 VLINK="#FFFFFF"
 ALINK="#FFFFFF"
>

  
      <!-- BOF: ./personal-templates/simple/business/layout/l27.layout --> 

<TABLE DIR="LTR" WIDTH=100% HEIGHT=100% BORDER=1 CELLPADDING=0 CELLSPACING=0>

        <tr>
<!-- Begin Slogan-->
                <td WIDTH=100% valign="top" BGCOLOR="#19130F">
                        <TABLE WIDTH=100% BORDER=0 CELLPADDING=0 CELLSPACING=0>
                                <TR>
                                        <TD WIDTH=100% HEIGHT=42 background="widgets/gen_898.1.gif">
                                                <IMG SRC="widgets/gen_897.1.gif" WIDTH=200 ALT=""></TD>
                                        <TD WIDTH=550 HEIGHT=42>
                                                <IMG SRC="widgets/gen_292.1.gif" WIDTH=550 ALT=""></TD>
                                </TR>
                        </TABLE>
                </td>
        </tr>
<!-- End Slogan-->
<!--Begin Name-->
        <tr>
                <td WIDTH=100% valign="top" BGCOLOR="#19130F">
                        <TABLE WIDTH=100% BORDER=0 CELLPADDING=0 CELLSPACING=0>
                                <TR>
                                        <TD WIDTH=750 HEIGHT=47 background="widgets/gen_900.1.gif">
                                                <IMG SRC="widgets/gen_899.1.gif" WIDTH=750 ALT=""></TD>
                                </TR>
                        </TABLE>
                </td>
        </tr>
<!--End Name-->
<!--Begin ris-->
        <tr>
                <td WIDTH=100% HEIGHT=100% valign="top" BGCOLOR="#19130F" VALIGN="top">
                        <TABLE WIDTH=100% HEIGHT=100% BORDER=0 CELLPADDING=0 CELLSPACING=0 VALIGN="top">
                                <tr>
                                        <td WIDTH=128 HEIGHT=100% valign="top" BGCOLOR="#675C56" VALIGN="top" background="widgets/gen_901.1.gif">
                                                <TABLE WIDTH=100% HEIGHT=100% BORDER=0 CELLPADDING=0 CELLSPACING=0 VALIGN="top">
                                                        <TR>
                                                                <TD WIDTH=128 HEIGHT=100% background="widgets/gen_901.1.gif" VALIGN="top">
                                                                        <IMG SRC="widgets/gen_295.1.gif" WIDTH=128 HEIGHT=339 ALT=""></TD>
                                                        </TR>
                                                </TABLE>        
                                        </td>
<!--End ris-->
<!--Begin center-->
                                        <TD WIDTH=100% HEIGHT=100% valign="top" BGCOLOR="#675C56" background =""><!-- BOF: ./personal-templates/simple/business/form/html -->
<!-- BOF: ./personal-templates/simple/personal/form/html -->


<center><table border=0>
<tr><td>


<font face='Arial' size='+1' color='#EDF2EA'>

Appointment

</font>


<br>
<SCRIPT LANGUAGE="JavaScript">
var BUILDER = '/studio/servlet/psoft.masonry.Builder';
function validate(frm){
var i = 0;

if (frm.field_55.value=="") return error(frm.field_55);

if (frm.field_60.value=="") return error(frm.field_60);

for(i = 0; i < frm.field_57.length; i++)
if (frm.field_57[i].checked) break;
if (frm.field_57.length==i) return error(frm.field_57[0]);
if (frm.field_y_56.value=="") return error(frm.field_y_56);

if (frm.field_59.value=="") return error(frm.field_59);

var url = document.URL;
if (url.indexOf(BUILDER) == -1 && url.charAt(url.length)!='/') {
    url = url.substring(0, url.lastIndexOf('/')+1);
}
frm.domain.value=url;
return true;
}
function error(field){ alert('You did not fill all required fields!'); field.focus(); return false; }
</SCRIPT>
<form name="questionary" action="http://69.49.230.9:8080/studio/servlet/psoft.customform.CustomForm" method="post">
<input type="hidden" name="domain" value="">
<input type="hidden" name="title" value="Appointment">
<input type="hidden" name="esubj" value="Submitted Form Report">
<input type="hidden" name="name" value="=GghoWXsbVRbLl=b">
<input type="hidden" name="submit_url" value="onsubmit.html">
<input type="hidden" name="error_url"  value="onerror.html">
<input type="hidden" name="order" value="55 60 57 d56 59 ">
<table border=0 cellpedding=5 cellspacing=5>

<input type="hidden" name="name_55" value="Name:">
<tr><td>


<font face='Arial' size='2' color='#FFFFFF'>

Name:

</font>


 <font color="red" size="-1">*</font></td><td>


<input type="text" name="field_55" size="">


</td></tr>

<input type="hidden" name="name_60" value="E-Mail Address:">
<tr><td>


<font face='Arial' size='2' color='#FFFFFF'>

E-Mail Address:

</font>


 <font color="red" size="-1">*</font></td><td>


<input type="text" name="field_60" size="">


</td></tr>

<input type="hidden" name="name_57" value="Will your appointment work for you?">
<tr><td>


<font face='Arial' size='2' color='#FFFFFF'>

Will your appointment work for you?

</font>


 <font color="red" size="-1">*</font></td><td>

<input type="radio" name="field_57" id="field_571" value="Yes"><label for="field_571">


<font face='Arial' size='2' color='#FFFFFF'>

Yes

</font>


</label> <input type="radio" name="field_57" id="field_572" value="No"><label for="field_572">


<font face='Arial' size='2' color='#FFFFFF'>

No

</font>


</label>


</td></tr>

<input type="hidden" name="name_56" value="Date of Appointment: ">
<tr><td>


<font face='Arial' size='2' color='#FFFFFF'>

Date of Appointment: 

</font>


 <font color="red" size="-1">*</font></td><td>


<select name="field_m_56" 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_56" 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_56" size="4" maxsize="4">

</td></tr>

<input type="hidden" name="name_59" value="Time Stated: ">
<tr><td>


<font face='Arial' size='2' color='#FFFFFF'>

Time Stated: 

</font>


 <font color="red" size="-1">*</font></td><td>


<input type="text" name="field_59" size="">


</td></tr>

<tr><td colspan=2 align=center>
    <input onClick="return validate(form)" type="submit" value="Submit">
    <input type="reset"  value="Reset">
    </td>
</tr>
</table>
</form>
</td></tr></table></center>
<!-- EOF: ./personal-templates/simple/personal/form/html -->

<!-- EOF: ./personal-templates/simple/business/form/html -->
</td>
<!--End center-->
<!-- Begin Menu-->
                                        <td WIDTH=221 HEIGHT=100% valign="top" BGCOLOR="#19130F" >
                                                <TABLE WIDTH=100% HEIGHT=100% BORDER=0 CELLPADDING=0 CELLSPACING=0 VALIGN="top">
                                                        <TR>
                                                                <TD WIDTH=221 HEIGHT=39>
                                                                        <IMG SRC="widgets/gen_297.1.gif" WIDTH=221 HEIGHT=39 ALT=""></TD>
                                                        </TR>
                                                        <TR>
                                                                <TD WIDTH=221 HEIGHT=20 background="widgets/gen_302.1.gif">
                                                                        
                                                                        <a href="index.html" onMouseOver="document.images['img6'].src='widgets/gen_905.1.gif'" onMouseOut="document.images['img6'].src='widgets/gen_904.1.gif'"><img src="widgets/gen_904.1.gif" alt="JAJ Home" name="img6" border="0"></a><br>
                                                                        <a href="services.html" onMouseOver="document.images['img14'].src='widgets/gen_907.1.gif'" onMouseOut="document.images['img14'].src='widgets/gen_906.1.gif'"><img src="widgets/gen_906.1.gif" alt="Services" name="img14" border="0"></a><br>
                                                                        <a href="gpage.html1.html" onMouseOver="document.images['img22'].src='widgets/gen_909.1.gif'" onMouseOut="document.images['img22'].src='widgets/gen_908.1.gif'"><img src="widgets/gen_908.1.gif" alt="Qualifications" name="img22" border="0"></a><br>
                                                                        <a href="faq.html" onMouseOver="document.images['img11'].src='widgets/gen_911.1.gif'" onMouseOut="document.images['img11'].src='widgets/gen_910.1.gif'"><img src="widgets/gen_910.1.gif" alt="FAQ" name="img11" border="0"></a><br>
                                                                        <a href="aluminum.html" onMouseOver="document.images['img165'].src='widgets/gen_981.1.gif'" onMouseOut="document.images['img165'].src='widgets/gen_980.1.gif'"><img src="widgets/gen_980.1.gif" alt="Aluminum Windows" name="img165" border="0"></a><br>
                                                                        <a href="faq1.html" onMouseOver="document.images['img99'].src='widgets/gen_913.1.gif'" onMouseOut="document.images['img99'].src='widgets/gen_912.1.gif'"><img src="widgets/gen_912.1.gif" alt="Window Glossary" name="img99" border="0"></a><br>
                                                                        <a href="form1.html" onMouseOver="document.images['img37'].src='widgets/gen_915.1.gif'" onMouseOut="document.images['img37'].src='widgets/gen_914.1.gif'"><img src="widgets/gen_914.1.gif" alt="Warranty" name="img37" border="0"></a><br>
                                                                        <a href="catalog.0.html" onMouseOver="document.images['img132'].src='widgets/gen_917.1.gif'" onMouseOut="document.images['img132'].src='widgets/gen_916.1.gif'"><img src="widgets/gen_916.1.gif" alt="JAJ Job Photos" name="img132" border="0"></a><br>
                                                                        <a href="Status.html" onMouseOver="document.images['img68'].src='widgets/gen_919.1.gif'" onMouseOut="document.images['img68'].src='widgets/gen_918.1.gif'"><img src="widgets/gen_918.1.gif" alt="JELD-WEN" name="img68" border="0"></a><br>
                                                                        <a href="norwoods.html" onMouseOver="document.images['img159'].src='widgets/gen_921.1.gif'" onMouseOut="document.images['img159'].src='widgets/gen_920.1.gif'"><img src="widgets/gen_920.1.gif" alt="Norwood" name="img159" border="0"></a><br>
                                                                        <a href="gpage.html" onMouseOver="document.images['img129'].src='widgets/gen_923.1.gif'" onMouseOut="document.images['img129'].src='widgets/gen_922.1.gif'"><img src="widgets/gen_922.1.gif" alt="WF Mold" name="img129" border="0"></a><br>
                                                                        
                                                                        <a href="form.html" onMouseOver="document.images['img51'].src='widgets/gen_927.1.gif'" onMouseOut="document.images['img51'].src='widgets/gen_926.1.gif'"><img src="widgets/gen_926.1.gif" alt="Appointment Confirmation" name="img51" border="0"></a><br>
                                                                        
                                                                        
                                                                        <a href="mailto:brian@jajconstruction.com" onMouseOver="document.images['img_email'].src='widgets/gen_933.1.gif'" onMouseOut="document.images['img_email'].src='widgets/gen_932.1.gif'"><img src="widgets/gen_932.1.gif" alt="e-mail me" name="img_email" border="0"></a><br>
                                                                </TD>
                                                        </TR>
                                                        <TR>
                                                                <TD WIDTH=221 HEIGHT=29>
                                                                        <IMG SRC="widgets/gen_298.1.gif" WIDTH=221 HEIGHT=29 ALT=""></TD>
                                                        </TR>
                                                        <TR>
                                                                <TD WIDTH=221 HEIGHT=142>
                                                                        <IMG SRC="widgets/gen_299.1.gif" WIDTH=221 HEIGHT=142 ALT=""></TD>
                                                        </TR>
                                                        <TR>
                                                                <TD WIDTH=221 HEIGHT="100%" VALIGN="top" background="widgets/gen_902.1.gif">
                                                                        <IMG SRC="widgets/gen_903.1.gif" WIDTH=221 HEIGHT=30 ALT=""></TD>
                                                        </TR>
                                                </TABLE>                
                                        </td>
                                </tr>
                        </TABLE>
                </td>
        </tr>
<!-- End Menu-->

<!-- Begin Last-->
        <tr>
                <TD BGCOLOR="#EDF2EA">
                        <IMG SRC="widgets/spacer.gif" WIDTH=1 HEIGHT=1></TD>
        </tr>
        <tr>    
                <TD BGCOLOR="#675C56">
                        

<br>
<FONT FACE="verdana, arial, helvetica" SIZE="1">
<center>
<nobr>|<a href="index.html">JAJ Home</A>|</nobr>

<nobr>|<a href="services.html">Services</A>|</nobr>

<nobr>|<a href="gpage.html1.html">Qualifications</A>|</nobr>

<nobr>|<a href="faq.html">FAQ</A>|</nobr>

<nobr>|<a href="aluminum.html">Aluminum Windows</A>|</nobr>

<nobr>|<a href="faq1.html">Window Glossary</A>|</nobr>

<nobr>|<a href="form1.html">Warranty</A>|</nobr>

<nobr>|<a href="catalog.0.html">JAJ Job Photos</A>|</nobr>

<nobr>|<a href="Status.html">JELD-WEN</A>|</nobr>

<nobr>|<a href="norwoods.html">Norwood</A>|</nobr>

<nobr>|<a href="gpage.html">WF Mold</A>|</nobr>

<nobr>|Appointment Confirmation|</nobr>
</center>
</font>

<br>
<center><table border="0" cellpadding="0" cellspacing="3"><tr><td align="center">

<br><font face="helvetica,verdana, arial" size="1">&nbsp;</font>

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

<!--End Last-->
</table>
<!-- EOF: ./personal-templates/simple/business/layout/l27.layout -->

    
<!-- BOF: ./personal-templates/simple/themes.show.body -->


<!-- EOF: ./personal-templates/simple/themes.show.body -->

</body>
<!-- BOF: ./personal-templates/simple/themes.show.end -->


<!-- EOF: ./personal-templates/simple/themes.show.end -->


</html>


<!-- EOF: ./personal-templates/show.body -->