Interpreter Feedback Form

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=82 BGCOLOR="#330066" TEXT="#F7F7FF"> <div> <FONT SIZE="5" COLOR="#FFFFFF" FACE="Arial" ><B>Professional Sign Language Interpreting, Inc.</B></FONT><B>     |   </B><B>  </B><A HREF="index.htm" TARGET="_top" TITLE="Professional Sign Language Interpreting,"><U><B>home</B></U></A></div> <div> <A HREF="id3.htm" TARGET="_top" TITLE=" About Us"><U> About Us</U></A>   |   <A HREF="id4.htm" TARGET="_top" TITLE="How to Use Interpreters"><U>How to Use Interpreters</U></A>   |   <A HREF="id6.htm" TARGET="_top" TITLE="Request an Interpreter"><U>Request an Interpreter</U></A>   |   <B>Interpreter Feedback Form</B>   |   <A HREF="id20.htm" TARGET="_top" TITLE="Emergency Services"><U>Emergency Services</U></A>   |   <A HREF="id21.htm" TARGET="_top" TITLE="VRI Service"><U>VRI Service</U></A>   |   <A HREF="id22.htm" TARGET="_top" TITLE="Info for Interpreters"><U>Info for Interpreters</U></A>   |   <A HREF="id23.htm" TARGET="_top" TITLE="Helpful Links"><U>Helpful Links</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#330066" TEXT="#F7F7FF"> <div>       <IMG SRC="0689f4c0.gif" border=0 width="159" height="76" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <DIV ALIGN="LEFT"></DIV> <div> <B>Why we want your FEEDBACK...</B></div> <div> You are the heart and soul of our service, and your feedback is crucial.  Please take the time after any assignment to send us positive or constructive feedback on your interpreter or any other part of our services.  Whether or not you include your name, all feedback is kept confidential.</div> </td> <td valign="top" height=398 BGCOLOR="#CCCCFF" TEXT="#080000"> <div> <I>Interpreter Feedback Form</I></div> <div>  <form action="http://csbmail.globalscape.com/cgi-bin/csbmail/csbmail.pl" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="Name,Phone,Email,Company,Date and time of assignment,Interpreter Name,Comments,Want a call back?,Job #"><input type="hidden" name="tlx_FormIndex" value="1"><input type="hidden" name="tlx_OKMessage" value="Thank you for your valuable feedback! We appreciate your comments and we are always trying to improve our services."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="feedback"><input type="hidden" name="tlx_EmailTo" value="psli@psli.net"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">Name:<br> <input type="text" name="Name" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Company:<br> <input type="text" name="Company" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Date and time of assignment:<br> <input type="text" name="Date and time of assignment" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Interpreter Name:<br> <input type="text" name="Interpreter Name" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Comments:<br> <textarea name="Comments" rows="5" cols="30"></textarea></td> </tr> <tr> <td align="left">Want a call back?:<br> <input type="text" name="Want a call back?" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Job #:<br> <input type="text" name="Job #" size="30" maxlength="100"></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> <TABLE BORDER="3" CELLPADDING="3" CELLSPACING="3" WIDTH="521" BORDERCOLORLIGHT="#9999CC" BORDERCOLORDARK="#330066" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" BGCOLOR=#6633CC > <tR> <tD VALIGN=TOP BGCOLOR=#330066 HEIGHT= 94 WIDTH="221"><div> <B>We look forward to working with you!</B></div> <div> <B>Contact us via email at </B></div> <div> <A HREF="mailto:psli@psli.net" TARGET="_top" TITLE="mailto:psli@psli.net"><U><B>mailto:psli@psli.net</B></U></A></div> </tD> <tD VALIGN=TOP BGCOLOR=#330066><NOBR><div> <B>PO Box 33557</B></div> <div> <B>Northglenn, CO  80233</B></div> <div> <B>303-920-7330 (Voice)</B></div> <div> <B>1-866-889-8647 (TTY user ID: PSLI)</B></div> <div> <B>303-920-7335 (FAX)</B></div> </NOBR></tD> </tR> </TABLE></div> <bR> <bR> </td> </tr></table></body>