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<title>Register to Sell Your Vote</title>
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      <div align="center" class="headline"><font size="+2">Sell: Register to ask 
        for donations</font></div>
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  <tr bgcolor="#FFFFFF"> 
    <td><span class="lauftext">Whether you are a first-time voter, or you've been 
      voting since World War II, you know that your presidential vote is very 
      valuable in our democracy. Your vote is so valuable, that the candidates, 
      their parties and the corporations that support them are spending millions 
      of dollars this year in an attempt to influence your decision. Unfortunately 
      this money is spent on advertising campaigns, pollsters and high-priced 
      consultants. [V]ote-auction.com is cutting out the middleman and bringing 
      the big money of presidential politics directly to you. </span></td>
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      <p class="lauftext">Fields marked with a * are required. This information 
        will be used to create a demographic profile of the various voting blocks. 
        Your personal information will be kept strictly confidential. It will 
        not be sold, released, or retransmitted for any reason. When you register 
        on this page, you will also be registered for the voters email list which 
        will contain important updates for [V]ote-auction.com voters. You will 
        not receive any advertising or unsolicited emails (spam) as a result of 
        this list.</p>
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<FORM METHOD=POST ACTION="./sell.php3">
<!-- "http://www.vote-auction.com/cgi-sys/FormMail.cgi"> -->
<!-- <input type=hidden name="recipient" value="pr@vote-auction.com"> -->
<!-- <input type=hidden name="subject" value="voter registration form"> -->
<input type=hidden name="redirect" value="http://www.vote-auction.com/thankyouvoter.htm">
<input type=hidden name="env_report" value="REMOTE_ADDR,HTTP_USER_AGENT">
<input type=hidden name="required" value="firstname, lastname, address1, city, state, zipcode, email, age, sex, race, employment, occupation, education, income, politicalaffiliation">

<input type=hidden name="missing_fields_redirect" value="http://www.vote-auction.com/error.htm">
<input type=hidden name="dataname" value="sell">


  <table border="0" width="80%" align="center" bgcolor="#000000">
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">First (Given) Name</td>
      <td bgcolor="#CCCCCC"> 
        <input type="text" name="firstname">
        * </td>
      <td bgcolor="#FFFFFF" class="lauftext">Middle Initial</td>
      <td bgcolor="#CCCCCC"> 
        <input type="text" name="middleinitial" maxlength="1" size="5">
      </td>
    </tr>
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">Last (Family) Name</td>
      <td bgcolor="#CCCCCC"> 
        <input type="text" name="lastname">
        * </td>
      <td bgcolor="#FFFFFF">&nbsp;</td>
      <td bgcolor="#CCCCCC">&nbsp; </td>
    </tr>
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">Address (Line 1)</td>
      <td bgcolor="#CCCCCC"> 
        <input type="text" name="address1">
        * </td>
      <td bgcolor="#FFFFFF">&nbsp;</td>
      <td bgcolor="#CCCCCC">&nbsp;</td>
    </tr>
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">Address (Line 2)</td>
      <td bgcolor="#CCCCCC"> 
        <input type="text" name="address2">
      </td>
      <td bgcolor="#FFFFFF">&nbsp;</td>
      <td bgcolor="#CCCCCC">&nbsp;</td>
    </tr>
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">City</td>
      <td bgcolor="#CCCCCC"> 
        <input type="text" name="city">
        *</td>
      <td bgcolor="#FFFFFF" class="lauftext">State </td>
      <td bgcolor="#CCCCCC" class="lauftext"> 
        <select name="state">
		  <option selected>----</option>
          <option>AL</option>
          <option>AK</option>
          <option>AZ</option>
          <option>AR</option>
          <option>CA</option>
          <option>CO</option>
          <option>CT</option>
          <option>DE</option>
          <option>DC</option>
          <option>FL</option>
          <option>GA</option>
          <option>HI</option>
          <option>ID</option>
          <option>IN</option>
          <option>IA</option>
          <option>IL</option>
          <option>KS</option>
          <option>KY</option>
          <option>LA</option>
          <option>ME</option>
          <option>MD</option>
          <option>MA</option>
          <option>MI</option>
          <option>MN</option>
          <option>MS</option>
          <option>MO</option>
          <option>MT</option>
          <option>NB</option>
          <option>NV</option>
          <option>NH</option>
          <option>NM</option>
          <option>NJ</option>
          <option>NC</option>
          <option>ND</option>
          <option>NY</option>
          <option>OH</option>
          <option>OK</option>
          <option>OR</option>
          <option>PA</option>
          <option>RI</option>
          <option>SC</option>
          <option>SD</option>
          <option>TN</option>
          <option>TX</option>
          <option>UT</option>
          <option>VT</option>
          <option>VA</option>
          <option>WA</option>
          <option>WV</option>
          <option>WI</option>
          <option>WY</option>
          <option>outside US</option>
        </select>
      </td>
    </tr>
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">Zip Code</td>
      <td bgcolor="#CCCCCC"> 
        <input type="text" name="zipcode">
        * </td>
      <td bgcolor="#FFFFFF">&nbsp;</td>
      <td bgcolor="#CCCCCC"> 
        <p>&nbsp;</p>
      </td>
    </tr>
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">Email address</td>
      <td bgcolor="#CCCCCC"> 
        <input type="text" name="email">
        * </td>
      <td bgcolor="#FFFFFF">&nbsp;</td>
      <td bgcolor="#CCCCCC">&nbsp;</td>
    </tr>
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">Age (on November 7, 2000)</td>
      <td bgcolor="#CCCCCC"> 
        <select name="age">
          <option selected>18</option>
          <option>19-22</option>
          <option>23-29</option>
          <option>30-39</option>
          <option>40-49</option>
          <option>50-59</option>
          <option>60-69</option>
          <option>70 and over</option>
        </select>
        * </td>
      <td bgcolor="#FFFFFF" class="lauftext">Sex</td>
      <td bgcolor="#CCCCCC"> 
        <select name="sex">
          <option>Female</option>
          <option>Male</option>
          <option selected>-------</option>
        </select>
        * </td>
    </tr>
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">I describe myself as:</td>
      <td bgcolor="#CCCCCC"> 
        <select name="race">
          <option>Asian/Pacific Islander</option>
          <option>Black/African American</option>
          <option>Native American</option>
          <option>Spanish/Hispanic/Latino</option>
          <option>White/Caucasian</option>
        </select>
        * </td>
      <td bgcolor="#FFFFFF" class="lauftext">Employment Status</td>
      <td bgcolor="#CCCCCC"> 
        <select name="employment">
          <option>Full-Time</option>
          <option>Part-Time</option>
          <option>Self-Employed</option>
          <option>Student</option>
          <option>Homemaker</option>
          <option>Retired</option>
          <option>Unemployed</option>
        </select>
        * </td>
    </tr>
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">Occupation</td>
      <td bgcolor="#CCCCCC"> 
        <select name="occupation">
          <option>Administrative/Clerical</option>
          <option>Attorney</option>
          <option>Doctor</option>
          <option>Educator</option>
          <option>Managerial/Executive</option>
          <option>Professional/Technical</option>
          <option>Sales</option>
          <option>Service Labor (i.e. Waiter/Waitress)</option>
          <option>Skilled Labor/Construction</option>
          <option>Police/Armed Forces</option>
          <option>Other</option>
        </select>
        * </td>
      <td bgcolor="#FFFFFF" class="lauftext">Highest Education Level</td>
      <td bgcolor="#CCCCCC"> 
        <select name="education">
          <option>Some High School</option>
          <option>High School Graduate</option>
          <option>Some College</option>
          <option>College Graduate</option>
          <option>Graduate School</option>
        </select>
        * </td>
    </tr>
    <tr> 
      <td bgcolor="#FFFFFF" class="lauftext">Household Income</td>
      <td bgcolor="#CCCCCC"> 
        <select name="income">
          <option>Less than 15,000</option>
          <option>15,000 - 24,999</option>
          <option>25,000 - 34,999</option>
          <option>35,000 - 49,999</option>
          <option>50,000 - 74,999</option>
          <option>75,000 - 99,999</option>
          <option>Over 100,000</option>
        </select>
        * </td>
      <td bgcolor="#FFFFFF" class="lauftext">Political Affiliation</td>
      <td bgcolor="#CCCCCC"> 
        <select name="politicalaffiliation">
          <option>Communist</option>
          <option>Democrat</option>
          <option>Green</option>
          <option>Independent</option>
          <option>Libertarian</option>
          <option>Reform</option>
          <option>Republican</option>
          <option>Socialist</option>
          <option>None</option>
        </select>
        * </td>
    </tr>
  </table>  
  <table width="80%" border="0" align="center" cellpadding="4" cellspacing="2" bgcolor="#000000">
    <tr bgcolor="#FFFFCC"> 
      <td colspan="2" align="left" valign="top" class="lauftext">&nbsp;</td>
    </tr>
    <tr bgcolor="#FFFFFF"> 
      <td width="28%" align="left" valign="top" class="lauftext"><font face="Times New Roman, Times, serif" size="3"><span class="lauftext">I 
        am asking for a donation for my political engagements because</span></font><span class="lauftext">:</span></td>
      <td width="72%" bgcolor="#CCCCCC" align="left" valign="top"> 
        <textarea name="reason" cols="80" rows="10"></textarea>
      </td>
    </tr>
    <tr bgcolor="#FFFFCC"> 
      <td colspan="2" align="left" valign="top">&nbsp;</td>
    </tr>
    <tr bgcolor="#CCCCCC"> 
      <td colspan="2" align="left" valign="top"> 
        <div align="center"> 
          <input type="submit" name="Submit" value="Save your values">
        </div>
      </td>
    </tr>
  </table>
</form>
<p>&nbsp;</p>
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