<?xml version="1.0"?>
<!DOCTYPE wml PUBLIC "-//WAPFORUM//DTD WML 1.1//EN" "http://www.wapforum.org/DTD/wml_1.1.xml">

<wml>

<card id="emergency" title="Emergency Assistance">

<onevent type="onenterforward">
  <refresh>
    <setvar name="x" value="1"/>
    <setvar name="t" value="emergency@with-intent.com"/>
    <setvar name="f" value="youremail@yourisp.com"/>
    <setvar name="s" value="Emergency Callback"/>
    <setvar name="m" value="xxx-555-1212"/>
  </refresh>
</onevent>

<p>
<br/>
<a href="index.wml">Home</a><br/>
<br/>Callback Form<br/>
<br/>
</p>
<p>To: <input name="t" format="*m"/></p>
<p>From: <input name="f" format="*m"/></p>
<p>Subject: <input name="s" format="*m"/></p>
<p>Phone Number: <input name="m" format="*m"/></p>

<p><anchor>Send
  <go href="http://www.ccwap.com/cgidir/wapmail_us.pl?x=1" method="post">
    <postfield name="x" value="1"/>
    <postfield name="t" value="$(t)"/>
    <postfield name="f" value="$(f)"/>
    <postfield name="s" value="$(s)"/>
    <postfield name="m" value="$(m)"/>
   </go>
</anchor></p>

<br/>
<p><br/>If your WAP browser does not support this form, click <a href="backup.wml">here</a>.</p>
<br/>

<do type="prev" label="Back"><prev/></do>
</card>
</wml>

