<HTML><HEAD><TITLE>Sign Up For Cult Radio E-Mail Newsletters!</TITLE> <BODY text=white vLink=blue link=blue bgColor=black><CENTER> <CENTER> <h1><font color="white">Sign Up To Receive The Latest Cult Radio News Via Email!</h1><br></font> <img src="http://www.cultradioagogo.com/images/craggsaverfront.jpg"><br><br> <form name="web_email" method="post" action="/cgi-bin/form-mail.cgi"> <input type="hidden" name="recipient" value="info@cultradioagogo.com"> <input type="hidden" name="subject" value="Add Me To The CRAGG Mailing List: http://www.cultradioagogo.com"> <input type="hidden" name="required" value="email,realname"> <input type="hidden" name="env_report" value="REMOTE_HOST,REMOTE_ADDR,HTTP_USER_AGENT"> <blockquote> <p>Name: <input type="text" size="27" name="realname" /> <p>Email:<b>*</b><input type="text" size="28" name="email" /> <p><e>How did you hear about us?</p> <select name="refer"> <option value="search_engine">Search Engine <option value="CTAGG">Cult Television A Go Go <option value="CRAGG">Cult Radio A Go Go <option value="friend">Friend - Word of mouth <option value="other">Other </select> <p>Comments: <br /><br> <textarea rows="8" name="feedback" cols="40"></textarea> <br /><br /> <input type="submit" value="Send Message" name="send"></p> <input type="reset" value="Clear" name="Clear"></p> </blockquote> </form> </center>