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										</TD>
									</TR>
									<TR>
									<TD align="center" valign="top" bgcolor="#184F21">
									<a href="http://pinepeakscrosslake.com/index.cfm/pageid/28"><font color="#ffffff" size="-1">Hot Deals</font></a>
									
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      <P align=center><FONT size=3><FONT face=Verdana><STRONG>Contact Us &amp; 
      Information Request 
      Form&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</STRONG></FONT></P>
      <P align=center><FONT face=Verdana size=2>Thank you for your interest in 
      Pine Peaks Lodge and Suites.<BR>So we may better serve your request please 
      fill out the form below<BR>and a representative will respond within 24 
      hours.</FONT></P>
      <P align=center>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
      </FONT></P></TD></TR>
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	<td valign="top"> 

		<font face="Verdana" size="1" color="000000" class="body">State 
		

		<br>
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				<option value="">Select Below</option>
				
					<option value="AA">Military AA</option>
				
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					<option value="AL">Alabama</option>
				
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					<option value="CA">California</option>
				
					<option value="CO">Colorado</option>
				
					<option value="CT">Connecticut</option>
				
					<option value="DC">District of Columbia</option>
				
					<option value="DE">Delaware</option>
				
					<option value="FL">Florida</option>
				
					<option value="GA">Georgia</option>
				
					<option value="GU">Guam</option>
				
					<option value="HI">Hawaii</option>
				
					<option value="IA">Iowa</option>
				
					<option value="ID">Idaho</option>
				
					<option value="IL">Illinois</option>
				
					<option value="IN">Indiana</option>
				
					<option value="KS">Kansas</option>
				
					<option value="KY">Kentucky</option>
				
					<option value="LA">Louisiana</option>
				
					<option value="MA">Massachusetts</option>
				
					<option value="MD">Maryland</option>
				
					<option value="ME">Maine</option>
				
					<option value="MI">Michigan</option>
				
					<option value="MN" selected>Minnesota</option>
				
					<option value="MO">Missouri</option>
				
					<option value="MS">Mississippi</option>
				
					<option value="MT">Montana</option>
				
					<option value="NC">North Carolina</option>
				
					<option value="ND">North Dakota</option>
				
					<option value="NE">Nebraska</option>
				
					<option value="NH">New Hampshire</option>
				
					<option value="NJ">New Jersey</option>
				
					<option value="NM">New Mexico</option>
				
					<option value="NV">Nevada</option>
				
					<option value="NY">New York</option>
				
					<option value="OH">Ohio</option>
				
					<option value="OK">Oklahoma</option>
				
					<option value="OR">Oregon</option>
				
					<option value="PA">Pennsylvania</option>
				
					<option value="PR">Puerto Rico</option>
				
					<option value="RI">Rhode Island</option>
				
					<option value="SC">South Carolina</option>
				
					<option value="SD">South Dakota</option>
				
					<option value="TN">Tennessee</option>
				
					<option value="TX">Texas</option>
				
					<option value="UT">Utah</option>
				
					<option value="VA">Virginia</option>
				
					<option value="VI">Virgin Islands</option>
				
					<option value="VT">Vermont</option>
				
					<option value="WA">Washington</option>
				
					<option value="WI">Wisconsin</option>
				
					<option value="WV">West Virginia</option>
				
					<option value="WY">Wyoming</option>
				</select> 
		</font>
	</td>

	
		</tr><tr>
	<td valign="top"> 

		<font face="Verdana" size="1" color="000000" class="body">Zip Code 
		

		<br>
		<input name="zip" id="zip" type="text" maxlength="20"  size="27"  />
		</font>
	</td>

	<td valign="top"> 

		<font face="Verdana" size="1" color="000000" class="body">Country 
		

		<br>
		<select name="country">

					<option value="Albania">Albania</option>
				
					<option value="Algeria">Algeria</option>
				
					<option value="Andorra">Andorra</option>
				
					<option value="Angola">Angola</option>
				
					<option value="Anguilla">Anguilla</option>
				
					<option value="Antigua & Barbuda">Antigua & Barbuda</option>
				
					<option value="Argentina">Argentina</option>
				
					<option value="Armenia">Armenia</option>
				
					<option value="Aruba">Aruba</option>
				
					<option value="Australia">Australia</option>
				
					<option value="Austria (EU Member)">Austria (EU Member)</option>
				
					<option value="Azerbaijan">Azerbaijan</option>
				
					<option value="Bahamas">Bahamas</option>
				
					<option value="Bahrain">Bahrain</option>
				
					<option value="Bangladesh">Bangladesh</option>
				
					<option value="Barbados">Barbados</option>
				
					<option value="Belarus">Belarus</option>
				
					<option value="Belgium (EU Member)">Belgium (EU Member)</option>
				
					<option value="Belize">Belize</option>
				
					<option value="Benin">Benin</option>
				
					<option value="Bermuda">Bermuda</option>
				
					<option value="Bolivia">Bolivia</option>
				
					<option value="Bosnia">Bosnia</option>
				
					<option value="Botswana">Botswana</option>
				
					<option value="Brazil">Brazil</option>
				
					<option value="British Virgin Isles">British Virgin Isles</option>
				
					<option value="Brunei">Brunei</option>
				
					<option value="Bulgaria">Bulgaria</option>
				
					<option value="Burkina Faso">Burkina Faso</option>
				
					<option value="Burundi">Burundi</option>
				
					<option value="Cambodia">Cambodia</option>
				
					<option value="Cameroon">Cameroon</option>
				
					<option value="Canada">Canada</option>
				
					<option value="Cape Verde">Cape Verde</option>
				
					<option value="Cayman Islands">Cayman Islands</option>
				
					<option value="Central African Rep">Central African Rep</option>
				
					<option value="Chad">Chad</option>
				
					<option value="Channel Islands">Channel Islands</option>
				
					<option value="Chile">Chile</option>
				
					<option value="China">China</option>
				
					<option value="Colombia">Colombia</option>
				
					<option value="Congo">Congo</option>
				
					<option value="Cook Islands">Cook Islands</option>
				
					<option value="Costa Rica">Costa Rica</option>
				
					<option value="Croatia">Croatia</option>
				
					<option value="Cyprus">Cyprus</option>
				
					<option value="Czech Republic">Czech Republic</option>
				
					<option value="Dem Rep of Congo (Zaire)">Dem Rep of Congo (Zaire)</option>
				
					<option value="Denmark (EU Member)">Denmark (EU Member)</option>
				
					<option value="Djibouti">Djibouti</option>
				
					<option value="Dominica">Dominica</option>
				
					<option value="Dominican Republic">Dominican Republic</option>
				
					<option value="Ecuador">Ecuador</option>
				
					<option value="Egypt">Egypt</option>
				
					<option value="El Salvador">El Salvador</option>
				
					<option value="Equatorial Guinea">Equatorial Guinea</option>
				
					<option value="Eritrea">Eritrea</option>
				
					<option value="Estonia">Estonia</option>
				
					<option value="Ethiopia">Ethiopia</option>
				
					<option value="Faeroe Islands">Faeroe Islands</option>
				
					<option value="Fiji">Fiji</option>
				
					<option value="Finland (EU Member)">Finland (EU Member)</option>
				
					<option value="France (EU Member)">France (EU Member)</option>
				
					<option value="French Guiana">French Guiana</option>
				
					<option value="French Polynesia/Tahiti">French Polynesia/Tahiti</option>
				
					<option value="Gabon">Gabon</option>
				
					<option value="Gambia">Gambia</option>
				
					<option value="Georgia">Georgia</option>
				
					<option value="Germany (EU Member)">Germany (EU Member)</option>
				
					<option value="Ghana">Ghana</option>
				
					<option value="Gibraltar">Gibraltar</option>
				
					<option value="Greece (EU Member)">Greece (EU Member)</option>
				
					<option value="Greenland">Greenland</option>
				
					<option value="Grenada">Grenada</option>
				
					<option value="Guadeloupe">Guadeloupe</option>
				
					<option value="Guam">Guam</option>
				
					<option value="Guatemala">Guatemala</option>
				
					<option value="Guinea">Guinea</option>
				
					<option value="Guinea-Bissau">Guinea-Bissau</option>
				
					<option value="Guyana">Guyana</option>
				
					<option value="Haiti">Haiti</option>
				
					<option value="Honduras">Honduras</option>
				
					<option value="Hong Kong">Hong Kong</option>
				
					<option value="Hungary">Hungary</option>
				
					<option value="Iceland">Iceland</option>
				
					<option value="India">India</option>
				
					<option value="Indonesia">Indonesia</option>
				
					<option value="Iran">Iran</option>
				
					<option value="Iraq">Iraq</option>
				
					<option value="Ireland (EU Member)">Ireland (EU Member)</option>
				
					<option value="Israel">Israel</option>
				
					<option value="Italy (EU Member)">Italy (EU Member)</option>
				
					<option value="Ivory Coast">Ivory Coast</option>
				
					<option value="Jamaica">Jamaica</option>
				
					<option value="Japan">Japan</option>
				
					<option value="Jordan">Jordan</option>
				
					<option value="Kazakhstan">Kazakhstan</option>
				
					<option value="Kenya">Kenya</option>
				
					<option value="Kiribati">Kiribati</option>
				
					<option value="Kuwait">Kuwait</option>
				
					<option value="Kyrgyzstan">Kyrgyzstan</option>
				
					<option value="Laos">Laos</option>
				
					<option value="Latvia">Latvia</option>
				
					<option value="Lebanon">Lebanon</option>
				
					<option value="Lesotho">Lesotho</option>
				
					<option value="Liberia">Liberia</option>
				
					<option value="Libya">Libya</option>
				
					<option value="Liechtenstein">Liechtenstein</option>
				
					<option value="Lithuania">Lithuania</option>
				
					<option value="Luxembourg">Luxembourg</option>
				
					<option value="Macau">Macau</option>
				
					<option value="Macedonia">Macedonia</option>
				
					<option value="Madagascar">Madagascar</option>
				
					<option value="Malawi">Malawi</option>
				
					<option value="Malaysia">Malaysia</option>
				
					<option value="Maldives">Maldives</option>
				
					<option value="Mali">Mali</option>
				
					<option value="Malta">Malta</option>
				
					<option value="Marshall Islands">Marshall Islands</option>
				
					<option value="Martinique">Martinique</option>
				
					<option value="Mauritania">Mauritania</option>
				
					<option value="Mauritius">Mauritius</option>
				
					<option value="Mexico">Mexico</option>
				
					<option value="Micronesia">Micronesia</option>
				
					<option value="Moldova">Moldova</option>
				
					<option value="Monaco (EU Member)">Monaco (EU Member)</option>
				
					<option value="Mongolia">Mongolia</option>
				
					<option value="Montserrat">Montserrat</option>
				
					<option value="Morocco">Morocco</option>
				
					<option value="Mozambique">Mozambique</option>
				
					<option value="Myanmar">Myanmar</option>
				
					<option value="N. Mariana Islands">N. Mariana Islands</option>
				
					<option value="Namibia">Namibia</option>
				
					<option value="Nepal">Nepal</option>
				
					<option value="Netherlands (EU Member)">Netherlands (EU Member)</option>
				
					<option value="Netherlands Antilles">Netherlands Antilles</option>
				
					<option value="New Caledonia">New Caledonia</option>
				
					<option value="New Zealand">New Zealand</option>
				
					<option value="Nicaragua">Nicaragua</option>
				
					<option value="Niger">Niger</option>
				
					<option value="Nigeria">Nigeria</option>
				
					<option value="Norfolk Island">Norfolk Island</option>
				
					<option value="Norway">Norway</option>
				
					<option value="Oman">Oman</option>
				
					<option value="Pakistan">Pakistan</option>
				
					<option value="Palau">Palau</option>
				
					<option value="Panama">Panama</option>
				
					<option value="Papua New Guinea">Papua New Guinea</option>
				
					<option value="Paraguay">Paraguay</option>
				
					<option value="Peru">Peru</option>
				
					<option value="Philippines">Philippines</option>
				
					<option value="Poland">Poland</option>
				
					<option value="Portugal (EU Member)">Portugal (EU Member)</option>
				
					<option value="Puerto Rico">Puerto Rico</option>
				
					<option value="Qatar">Qatar</option>
				
					<option value="Reunion Isl.">Reunion Isl.</option>
				
					<option value="Romania">Romania</option>
				
					<option value="Russia">Russia</option>
				
					<option value="Rwanda">Rwanda</option>
				
					<option value="Samoa (Amer.)">Samoa (Amer.)</option>
				
					<option value="Samoa (Western)">Samoa (Western)</option>
				
					<option value="San Marino">San Marino</option>
				
					<option value="Saudi Arabia">Saudi Arabia</option>
				
					<option value="Senegal">Senegal</option>
				
					<option value="Seychelles">Seychelles</option>
				
					<option value="Sierra Leone">Sierra Leone</option>
				
					<option value="Singapore">Singapore</option>
				
					<option value="Slovakia">Slovakia</option>
				
					<option value="Slovenia">Slovenia</option>
				
					<option value="Solomon Islands">Solomon Islands</option>
				
					<option value="South Africa">South Africa</option>
				
					<option value="South Korea">South Korea</option>
				
					<option value="Spain (EU Member)">Spain (EU Member)</option>
				
					<option value="Sri Lanka">Sri Lanka</option>
				
					<option value="St. Christopher">St. Christopher</option>
				
					<option value="St. Lucia">St. Lucia</option>
				
					<option value="St. Vincent/Grenadines">St. Vincent/Grenadines</option>
				
					<option value="Sudan">Sudan</option>
				
					<option value="Suriname">Suriname</option>
				
					<option value="Swaziland">Swaziland</option>
				
					<option value="Sweden (EU Member)">Sweden (EU Member)</option>
				
					<option value="Switzerland">Switzerland</option>
				
					<option value="Syria">Syria</option>
				
					<option value="Taiwan">Taiwan</option>
				
					<option value="Tajikistan">Tajikistan</option>
				
					<option value="Tanzania">Tanzania</option>
				
					<option value="Thailand">Thailand</option>
				
					<option value="Togo">Togo</option>
				
					<option value="Tonga">Tonga</option>
				
					<option value="Trinidad & Tobago">Trinidad & Tobago</option>
				
					<option value="Tunisia">Tunisia</option>
				
					<option value="Turkey">Turkey</option>
				
					<option value="Turkmenistan">Turkmenistan</option>
				
					<option value="Turks & Caicos Isl.">Turks & Caicos Isl.</option>
				
					<option value="Tuvalu">Tuvalu</option>
				
					<option value="Uganda">Uganda</option>
				
					<option value="Ukraine">Ukraine</option>
				
					<option value="United Arab Emirates">United Arab Emirates</option>
				
					<option value="United Kingdom (EU Member)">United Kingdom (EU Member)</option>
				
					<option value="United States" selected>United States</option>
				
					<option value="Uruguay">Uruguay</option>
				
					<option value="US Virgin Islands">US Virgin Islands</option>
				
					<option value="Uzbekistan">Uzbekistan</option>
				
					<option value="Vanuatu">Vanuatu</option>
				
					<option value="Venezuela">Venezuela</option>
				
					<option value="Vietnam">Vietnam</option>
				
					<option value="Wake Island">Wake Island</option>
				
					<option value="Wallis & Futuna Isle">Wallis & Futuna Isle</option>
				
					<option value="Yemen">Yemen</option>
				
					<option value="Yugoslavia">Yugoslavia</option>
				
					<option value="Zambia">Zambia</option>
				
					<option value="Zimbabwe">Zimbabwe</option>
				</select> 
		</font>
	</td>

	
		</tr><tr>
	<td valign="top"> 

		<font face="Verdana" size="1" color="000000" class="body">Phone 
		

		<br>
		<input name="HPhone" id="HPhone" type="text" maxlength="20"  size="27"  />
		</font>
	</td>

	<td valign="top"> 

		<font face="Verdana" size="1" color="000000" class="body">Fax 
		

		<br>
		<input name="fax" id="fax" type="text" maxlength="20"  size="27"  />
		</font>
	</td>

	
		</tr><tr>
	<td valign="top"> 

		<font face="Verdana" size="1" color="000000" class="body">Email 
		

		<br>
		<input name="Email" id="Email" type="text" maxlength="50"  size="27"  />
		</font>
	</td>

	
		</tr><tr>
	<td colspan="2" valign="top">
	

		<font face="Verdana" size="1" color="000000" class="body">Please inform me of any specials or upcoming events. 
		

		<br>
		
				<table cellpadding=0 cellspacing=3 border=0><tr>
				</tr><tr>
					<td width="25%" valign="top"><table cellpadding=0 cellspacing=0 border=0><tr><td valign="top"><font face="Verdana" size="1" color="000000" class="body"><input type="radio" name="Field_14" value="Yes" checked></font></td><td valign="top"><font face="Verdana" size="1" color="000000" class="body">Yes</font></td></tr></table></td>
					
					<td width="25%" valign="top"><table cellpadding=0 cellspacing=0 border=0><tr><td valign="top"><font face="Verdana" size="1" color="000000" class="body"><input type="radio" name="Field_14" value="No" ></font></td><td valign="top"><font face="Verdana" size="1" color="000000" class="body">No</font></td></tr></table></td>
					
				</tr></table>
			
		</font>
	</td>

	
		</tr><tr>
	<td colspan="2" valign="top">
	

		<font face="Verdana" size="1" color="000000" class="body">I am interested in 
		

		<br>
		
				<table cellpadding=0 cellspacing=3 border=0><tr>
				</tr><tr>
					<td width="25%" valign="top"><table cellpadding=0 cellspacing=0 border=0><tr><td valign="top"><font face="Verdana" size="1" color="000000" class="body"><input type="checkbox" name="Field_15" value="Vacations"></font></td><td valign="top"><font face="Verdana" size="1" color="000000" class="body">Vacations</font></td></tr></table></td>
					
					<td width="25%" valign="top"><table cellpadding=0 cellspacing=0 border=0><tr><td valign="top"><font face="Verdana" size="1" color="000000" class="body"><input type="checkbox" name="Field_15" value="Long term stay"></font></td><td valign="top"><font face="Verdana" size="1" color="000000" class="body">Long term stay</font></td></tr></table></td>
					
					<td width="25%" valign="top"><table cellpadding=0 cellspacing=0 border=0><tr><td valign="top"><font face="Verdana" size="1" color="000000" class="body"><input type="checkbox" name="Field_15" value="Group booking"></font></td><td valign="top"><font face="Verdana" size="1" color="000000" class="body">Group booking</font></td></tr></table></td>
					
					<td width="25%" valign="top"><table cellpadding=0 cellspacing=0 border=0><tr><td valign="top"><font face="Verdana" size="1" color="000000" class="body"><input type="checkbox" name="Field_15" value="Special event"></font></td><td valign="top"><font face="Verdana" size="1" color="000000" class="body">Special event</font></td></tr></table></td>
					</tr><tr>
					<td width="25%" valign="top"><table cellpadding=0 cellspacing=0 border=0><tr><td valign="top"><font face="Verdana" size="1" color="000000" class="body"><input type="checkbox" name="Field_15" value="area activity"></font></td><td valign="top"><font face="Verdana" size="1" color="000000" class="body">area activity</font></td></tr></table></td>
					
				</tr></table>
			
		</font>
	</td>

	
		</tr><tr>
	<td colspan="2" valign="top">
	

		<font face="Verdana" size="1" color="000000" class="body">Comments / Information Request Form: 
		

		<br>
		<textarea cols="49" rows="4" name="Field_16"></textarea>
		</font>
	</td>

	
		</tr><tr>
	<td colspan="2" valign="top">
	

		<font face="Verdana" size="1" color="000000" class="body">All information will be held confidential by Pine Peaks Lodge and Suites! 
		

		<br>
		
		</font>
	</td>

	
		</tr>
		</table>
	</td>
</tr>

<tr>
    <td nowrap align="center"><nobr><input type="submit" value=" Send Form " class="button"></nobr></td>
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