<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" >
<head>
<title></title>
<script language="javascript">
    function loadCaptacha() {
        var randomnumber = Math.floor(Math.random() * 11111);
        var CaptachaNum = randomnumber + "569";
        CaptachaNum = CaptachaNum.substring(0, 4);
        document.getElementById("divCaptacha").innerHTML = CaptachaNum;
        document.ContactUs.tmpCap.value = CaptachaNum;
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        txt = "";
        if (document.ContactUs.txtFirstName.value == "") {
            txt = txt + "Please fill in your First Name\n";
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        if (document.ContactUs.txtLastName.value == "") {
            txt = txt + "Please fill in your Last Name\n";
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        if (document.ContactUs.txtEmail.value == "" ||
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    		document.ContactUs.txtEmail.value.length < 6) {
            txt = txt + "Please enter a Vaild Email Address\n";
            valid = false;
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        if (document.ContactUs.txtNote4.value == "") {
            txt = txt + "Please enter your Message/Comments\n";
            valid = false;
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        var cptxt = document.getElementById("txtCaptacha").value;
        var Captacha = document.getElementById("divCaptacha").innerHTML;

        if (cptxt != Captacha) {
            txt = txt + "Captcha number does not Match.";
            valid = false;
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        if (valid == false)
        { alert(txt); }

        return valid;
    }	

</script>
    </head>
    <body onLoad="javascript:loadCaptacha();">
        <link id="_injection_graph_nh_css" class="skype_name_highlight_style" rel="stylesheet" type="text/css" href="chrome://skype_ff_toolbar_win/content/injection_nh_graph.css" charset="utf-8">
        <link id="_skypeplugin_dropdownmenu_css" rel="stylesheet" type="text/css" href="chrome://skype_ff_toolbar_win/content/skypeplugin_dropdownmenu.css" charset="utf-8">
        <script charset="utf-8" id="injection_graph_func" src="chrome://skype_ff_toolbar_win/content/injection_graph_func.js"></script>
        <script id="_nameHighlight_injection"></script>
        <script charset="utf-8" id="injection_graph_func" src="chrome://skype_ff_toolbar_win/content/injection_graph_func.js"></script>
        <script id="_nameHighlight_injection"></script>
        <form id="ContactUs" onSubmit="return checkform();" method="post" name="ContactUs" action="https://post.salesoptima.com/wcmpost.aspx">
            <div align="center"></div>
            <input value="" name="tmpCap" type="hidden">
            <table style="border-collapse: collapse; font-family: Verdana; font-size: 12px;" align="center" border="0" cellpadding="0" cellspacing="0" width="800">
                <tbody>
                    <tr align="middle">
                        <td style="padding-bottom: 15px;" colspan="2">&nbsp;<A href="http://www.garywelchhomeloans.com/" target=_blank><IMG style="WIDTH: 476px; HEIGHT: 117px" border=0 alt="GWHL logo" src="http://www.garywelchhomeloans.com/branding/images/LogoGreen_483.jpg" ??=""></A></td>
                    </tr>
                    <tr>
                        <td style="padding-bottom: 15px;" colspan="2">
                        <p align="center"><font style="font-size: 12pt;"><span style="font-size: 12pt;"><strong>Contact Gary</strong></span></font></p>
                        </td>
                    </tr>
                    <tr>
                        <td style="padding-bottom: 10px; padding-top: 10px;" colspan="2" valign="center"><FONT style="FONT-SIZE: 13px" face=Verdana><span class="Apple-style-span" style="TEXT-ALIGN: left; BORDER-COLLAPSE: collapse; FONT-FAMILY: Verdana; FONT-SIZE: 13px">Please fill out the form below or contact me directly at 770.888.2232 or<SPAN class=Apple-converted-space>&nbsp;</SPAN><A href="mailto:gary@garywelchhomeloans.com">gary@garywelchhomeloans.com</A>.</span></FONT></td>
                    </tr>
                    <tr>
                        <td style="padding-bottom: 10px; padding-top: 10px;" colspan="2" valign="center">
                        <hr width="100%" size="1">
                        </td>
                    </tr>
                    <tr>
                        <td><font style="font-size: 8pt;">*First Name:</font></td>
                        <td width="78%" style="padding-bottom: 5px; padding-top: 5px;"><input style="width: 175px;" name="txtFirstName" dpieagent_iecontroltype="2"></td>
                    </tr>
                    <tr>
                        <td><font style="font-size: 8pt;">*Last Name:</font></td>
                        <td style="padding-bottom: 5px; padding-top: 5px;"><input style="width: 175px;" name="txtLastName" dpieagent_iecontroltype="2"></td>
                    </tr>
                    <tr>
                        <td><font style="font-size: 8pt;">Street Address:</font></td>
                        <td style="padding-bottom: 5px; padding-top: 5px;"><input style="width: 175px; height: 22px;" name="txtAdd1" dpieagent_iecontroltype="2"></td>
                    </tr>
                    <tr>
                        <td><font style="font-size: 8pt;">City, ST, Zip:</font></td>
                        <td style="padding-bottom: 5px; padding-top: 5px;"><input style="width: 175px; height: 22px;" name="txtCity" dpieagent_iecontroltype="2">&nbsp; <input style="width: 100px; height: 22px;" name="txtState" dpieagent_iecontroltype="2">&nbsp; <input style="width: 100px; height: 22px;" name="txtZip" dpieagent_iecontroltype="2"></td>
                    </tr>
                    <tr>
                        <td><font style="font-size: 8pt;">*Phone:</font></td>
                        <td style="padding-bottom: 5px; padding-top: 5px;"><input style="width: 175px;" name="txtPhone" dpieagent_iecontroltype="2"></td>
                    </tr>
                    <tr>
                        <td><font style="font-size: 8pt;">*Email:</font></td>
                        <td style="padding-bottom: 5px; padding-top: 5px;"><input style="width: 300px;" name="txtEmail" dpieagent_iecontroltype="2"></td>
                    </tr>
                    <tr>
                        <td>Contact Preference:</td>
                        <td style="padding-bottom: 5px; padding-top: 5px;">Phone <input value="Phone" name="txtNote1" type="radio">&nbsp;&nbsp; &nbsp;Email <input value="Email" name="txtNote1" type="radio">&nbsp;&nbsp;&nbsp; N/A&nbsp; <input value="N/A" name="txtNote1" type="radio"></td>
                    </tr>
                    <TR>
                      <TD><FONT style="FONT-SIZE: 8pt">Company:</FONT></TD>
                      <TD style="PADDING-BOTTOM: 5px; PADDING-TOP: 5px"><FONT style="FONT-SIZE: 8pt">Do you work for UPS?&nbsp;&nbsp;&nbsp; Yes
                        <INPUT value=Yes type=radio name=txtNote2>
                        &nbsp;&nbsp;No&nbsp;
                        <INPUT value=No type=radio name=txtNote2>
                        &nbsp;&nbsp;<BR>
                        <BR>
                        If "no", enter company name&nbsp;
                        <INPUT style="WIDTH: 175px" name=txtCompanyName dpieagent_iecontroltype="2">
                        &nbsp;(optional)</FONT></TD>
                    </TR>
                    <tr>
                        <td style="padding-bottom: 10px; padding-top: 10px;" colspan="2" valign="center">
                        <hr width="100%" size="1">
                        <table>
                            <tbody>
                                <tr>
                                    <td><font style="font-size: 8pt;">&nbsp;<font style="font-size: 8pt;">Reason for Contact:</font></font></td>
                                    <td><font style="font-size: 8pt;">&nbsp;Refinance&nbsp;<input value="Refinance" name="txtNote3" type="radio"></font></td>
                                    <td><font style="font-size: 8pt;">&nbsp;<font style="font-size: 8pt;">Purchase&nbsp; </font><input value="Purchase" name="txtNote3" type="radio">&nbsp; </font></td>
                                    <td><font style="font-size: 8pt;">&nbsp;General Inquiry&nbsp;<input value="General Inquiry" name="txtNote3" type="radio"></font></td>
                                    <td><font style="font-size: 8pt;">&nbsp;Other </font><font style="font-size: 8pt;"><input value="Other" name="txtNote3" type="radio"></font></td>
                                </tr>
                            </tbody>
                        </table>
                        </td>
                    </tr>
                    <tr>
                        <td style="padding-top: 5px;" valign="top" width="22%"><font style="font-size: 8pt;">*Message/Comments:</font></td>
                        <td style="padding-bottom: 5px; padding-top: 5px;" valign="top"><textarea style="width: 600px;" rows="8" cols="48" name="txtNote4"></textarea></td>
                    </tr>
                    <tr> 
<td>Captcha Number:</td> 
<td><div id="divCaptacha" style="background-color:#dbd8d8; height:35px;width:160px; font-weight: bold;"></div></td> 
</tr> 
<tr style="height:20px"> 
<td></td> 
<td></td> 
</tr> 
<tr> 
<td>Enter Captacha Number:</td> 
<td><input type="text" id="txtCaptacha"/></td> 
</tr> 
<tr style="height:20px"> 
<td></td> 
<td></td> 
</tr>
                    <tr>
                        <td style="padding-top: 20px;" colspan="2">
                        <p align="center">&nbsp;&nbsp;<input style="width: 100px; height: 22px;" value="Contact Preference" name="txtNote1Title" type="hidden">
                          <input name="txtNote2Title" type="hidden" id="txtNote2Title" style="width: 100px; height: 22px;" value="Do you work for UPS">
                          &nbsp;&nbsp;<input style="width: 100px; height: 22px;" value="Reason for Contact" name="txtNote3Title" type="hidden">&nbsp;<input style="width: 100px; height: 22px;" value="Message/Comments" name="txtNote4Title" type="hidden"> <input value="http://www.garywelchhomeloans.com/" name="RedirectURL" type="hidden"> <input id="Submit" value="Contact Now" name="Submit" type="submit" onClick="JudgeMe();"><input value="O1GZBWSXRGRPMUAA5OQXTUVQKBON" name="LinkCode" type="hidden"> </p>
                        </td>
                    </tr>
                    <tr>
                        <td style="padding-top: 20px;" colspan="2"><span style="PADDING-TOP: 20px"><FONT style="FONT-SIZE: 8pt"><A href="http://www.garywelchhomeloans.com/" target=_blank>Return to</A></FONT>&nbsp; <A href="http://www.garywelchhomeloans.com/" target=_blank><IMG style="WIDTH: 170px; HEIGHT: 21px" border=0 alt="GWHL button" align=absMiddle src="http://www.garywelchhomeloans.com/emailupdates/images/btnGaryWelch.jpg" ??=""></A></span><br>
                        </td>
                    </tr>
                </tbody>
            </table>
        </form>
    </body>
</html>
