[civ]

Here is the form output - let me know if you'd prefer the entire page:

<form action="usercheckout.html" method="POST" name="addlisting" onSubmit="return checkform(this)">
<table class="tableborder">
	<tr>
		<th colspan="2"><img height="8" src="images/nav_m.gif" width="8" /> <strong>Extra Options</strong></th>
	</tr>
		<tr>
          <td class="formleft">Make your listing featured: <a href="pages.php?page=7" target="_blank"><u>Example</u></a> <small>(opens in new window)</small></td>
          <td class="formright">
			<select name="featured">
			     <option value="N" >No Thanks</option>
			     <option value="Y"  selected>Yes (+$1.00)</option>
			</select>
		</td>
	</tr>
			<tr>
          <td class="formleft">Make your listing bold: <a href="pages.php?page=7" target="_blank"><u>Example</u></a> <small>(opens in new window)</small></td>
          <td class="formright">
			<select name="bold">
			     <option value="N"  selected>No Thanks</option>
			     <option value="Y" >Yes (+$0.50)</option>
			</select>
		</td>
	</tr>
			<tr>
	     <td class="formleft">Make your listing highlighted: <a href="pages.php?page=7" target="_blank"><u>Example</u></a> <small>(opens in new window)</small></td>
		<td class="formright">
			<select name="highlighted">
			     <option value="N"  selected>No Thanks</option>
			     <option value="Y" >Yes (+$0.50)</option>
			</select>
		</td>
	</tr>
		<tr>
	     <td class="formleft">Coupon or Discount Number: <small>(Applies to entire listing cost, including Extra Options above)</small></td>
		<td class="formright"><input name="coupon" type="text" /></td>
	</tr>
</table>
<br />
<table class="tableborder">
	<tr>
		<th colspan="2"><img height="8" src="images/nav_m.gif" width="8" /> <strong>Add Listing</strong></th>
	</tr>
		<tr>
		<td class="formstrip" colspan="2"><font color="#FF0000">We're sorry!  The coupon you entered above is invalid or has expired. It will not be reflected in your order total.<br /><br />Please re-enter the coupon or click Continue below to complete your order.</font></td>
	</tr>
		<tr>
		<td class="formstrip" colspan="2">Please enter the ad details below</td>
	</tr>
	<tr>
		<td class="formleft">* Title:</td>
		<td class="formright"><input name="title" type="text" size="30" onKeyDown="textTitleCounter(this.form.title,this.form.remLentext,20);" onKeyUp="textTitleCounter(this.form.title,this.form.remLentext,20);" value="test10" /><br /><span class="characters">Characters Remaining: <span id="cCharTitleLeft" class="characters"></span>/20</span></td>
	</tr>
		<tr>
		<td class="formleft">Price:</td>
		<td class="formright">$<input name="price" type="text" size="30" value="1000" /></td>
	</tr>
			<tr>
		<td class="formleft">Website: (must include http://)</td>
		<td class="formright"><input name="url" type="text" size="30" value="www.google.com" /></td>
	</tr>
				<tr>
		<td class="formleft">Description:</td>
		<td class="formright"><textarea name="description" id="description" cols="35" rows="4" onKeyDown="textCounter(this.form.description,this.form.remLentext,1000);" onKeyUp="textCounter(this.form.description,this.form.remLentext,1000);">test description</textarea><br /><span class="characters">Characters Remaining: <span id="cCharLeft"></span>/1000</span></td>
	</tr>
		<tr><td align='left' class="formleft"> Shipping Availability:</td><td align='left' class="formright"><select name="opt1"><option value="Pickup Only">Pickup Only</option>
<option value="Shipping is Available">Shipping is Available</option>
</select></td></tr>
		</td>
	</tr>
</table>
<br />
<div align="center"><input type="submit" name="Submit" value="Continue" /></div>
<input name="section" type="hidden" value="181" />
<input name="productid" type="hidden" value="1" />
<input name="step" type="hidden" value="4" />
</form>