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<form enctype="multipart/form-data" action="http://lhnresponder.com/ar/subc.php" method="post">
    <table width="10%">
        <input type="hidden" value="41" name="aid" /> <input type="hidden" value="lemail,lfname" name="required" /> <input type="hidden" value="mysite.htm" name="filledfrm" />
        <tbody>
            <tr>
                <td><font face="Arial, Helvetica, sans-serif" size="2">First Name:<br />
                <input type="text" size="15" name="lfname" /></font></td>
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                <td><font face="Arial, Helvetica, sans-serif" size="2">E-Mail Address:<br />
                <input type="text" size="15" name="lemail" /></font></td>
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                <td><font face="Arial, Helvetica, sans-serif" size="2">Country:<br />
                <input type="text" size="15" name="lcountry" /></font></td>
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                <td><br />
                Subscribe By: <br />
                (Select One Only) <br />
                <input type="checkbox" value="Y" name="EMAILN" /> E-Mail<br />
                <input type="checkbox" value="Y" name="RSSF" /> RSS Feed <br />
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                <input type="submit" value="Subscribe" name="submit" /> </td>
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