<h2>
	Request a Price Quote</h2>
<p>
	For information about how you can you can receive your free Price Quote, call 1-888-983-3012 or email us at <a href="mailto:sales@translogisticsinc.com">sales@translogisticsinc.com</a>, or complete the following form to request pricing.</p>
<hr />
<form action="quote.php" method="post" name="Form1" onsubmit="">
	<table border="0" cellpadding="0" cellspacing="0" width="600">
		<tbody>
			<tr>
				<td>
					<h3>
						Your Contact Information</h3>
				</td>
			</tr>
			<tr>
				<td>
					<table border="0" cellpadding="0" cellspacing="0" width="100%">
						<tbody>
							<tr>
								<td>
									<p>
										First Name:</p>
								</td>
								<td>
									<input id="txtFirstName" name="txtFirstName" size="30" type="text" /></td>
							</tr>
							<tr>
								<td>
									<p>
										Last Name:</p>
								</td>
								<td>
									<input id="txtLastName" name="txtLastName" size="30" type="text" /></td>
							</tr>
							<tr>
								<td>
									<p>
										Title:</p>
								</td>
								<td>
									<input id="txtTitle" name="txtTitle" size="30" type="text" /></td>
							</tr>
							<tr>
								<td>
									<p>
										Company:</p>
								</td>
								<td>
									<input id="txtCompany" name="txtCompany" size="30" type="text" /></td>
							</tr>
							<tr>
								<td>
									<p>
										Phone:</p>
								</td>
								<td>
									<input class="form_textfield" id="txtPhone" name="txtPhone" size="30" type="text" /></td>
							</tr>
							<tr>
								<td>
									<p>
										Email Address:</p>
								</td>
								<td>
									<input id="txtEmail" name="txtEmail" size="30" type="text" /></td>
							</tr>
							<tr>
								<td>
									<p>
										State:</p>
								</td>
								<td>
									<select id="State" name="State"><option selected="selected" value="">Please select a state</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District Of Columbia">District Of Columbia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select></td>
							</tr>
							<tr>
								<td>
									<p>
										A brief description:</p>
								</td>
								<td>
									<textarea cols="30" id="txtComments" name="txtComments" rows="5"></textarea></td>
							</tr>
							<tr>
								<td colspan="2">
									<p>
										<input checked="checked" id="mailingList" name="mailingList" type="checkbox" />&nbsp;&nbsp;&nbsp;&nbsp; I would like to be added to the TLI mailing list.</p>
								</td>
							</tr>
							<tr>
								<td align="center" colspan="2">
									<input id="Submit" name="Submit" type="submit" value="Submit" /></td>
							</tr>
						</tbody>
					</table>
				</td>
			</tr>
		</tbody>
	</table>
</form>
<p>
	&nbsp;</p>
