--- /dev/null
+<html>
+ <head></head>
+ <body>
+ <div>
+ <h1>Dialer</h1>
+ <form name="appform" id="appform" method="post">
+ <div id="city_div"> City:
+ <input /="/" name="city" type="text">
+ </div>
+ <div id="state_div"> State:
+ <input /="/" value="catatonic" name="state" type="text">
+ </div>
+ <div id="company_div"> Company:
+ <input /="/" name="company" type="text">
+ </div>
+ <div id="data_source_div"> Data Source:
+ <input /="/" name="data_source" type="text">
+ </div>
+ <input /="/" value="locate records" type="submit">
+ </form>
+ </div>
+ </body>
+</html>