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<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=30 BGCOLOR="#006699" TEXT="#080000"> <div> <FONT SIZE="3" COLOR="#FFFFFF" FACE="Arial" ><B>Northeast NDE Company</B></FONT><B> </B><B> </B><FONT SIZE="1" COLOR="#FFFFCC" FACE="Arial" ><B>   |     </B><A HREF="index.htm" TARGET="_top" TITLE="Northeast NDE Company"><U><B>home</B></U></A></FONT></div> <div> <A HREF="id2.htm" TARGET="_top" TITLE="What is NDE?"><U>What is NDE?</U></A>   |   <A HREF="id3.htm" TARGET="_top" TITLE="Products and Services"><U>Products and Services</U></A>   |   <B>More Information</B>   |   <A HREF="id6.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=160 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <A HREF="index.htm" TARGET="_top" TITLE="Northeast NDE Company"><U><IMG SRC="12e8f710.jpg" border=0 width="143" height="113" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A></div> <div> <A HREF="id2.htm" TARGET="_top" TITLE="What is NDE?"><U><B>What is NDE?</B></U></A></div> <div> <A HREF="id3.htm" TARGET="_top" TITLE="Products and Services"><U><B>Products and Services</B></U></A></div> <div> <B>More Information</B></div> <div> <A HREF="id6.htm" TARGET="_top" TITLE="Contact Us"><U><B>Contact Us</B></U></A></div> </td> <td valign="top" height=450 BGCOLOR="#EEEEEE" TEXT="#080000"> <div> <I>More Information</I></div> <div> If you would like to request information, please fill out the form with your contact</div> <div> information. Be sure to include specific questions or inquiries in the comments box. </div> <bR> <div> Thank you.</div> <bR> <div>  <form action="http://formmail.trellix.com/servlets/TlxMailer" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="LastName,FirstName,Email,Company,Address1,Address2,City,State,Zip,[Custom],Phone,Fax,MailingList,Comments"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thank you for your request for information. Someone will contact you within the next few business days."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="A request form was submitted"><input type="hidden" name="tlx_EmailTo" value="info@northeastnde.com"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">Last Name:<br> <input type="text" name="LastName" size="50" maxlength="100"></td> </tr> <tr> <td align="left">First Name:<br> <input type="text" name="FirstName" size="50" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="50" maxlength="100"></td> </tr> <tr> <td align="left">Company:<br> <input type="text" name="Company" size="50" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 1:<br> <input type="text" name="Address1" size="50" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 2:<br> <input type="text" name="Address2" size="50" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="50" maxlength="100"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="20" maxlength="10"></td> </tr> <tr> <td align="left">Zip or Postal Code:<br> <input type="text" name="Zip" size="20" maxlength="10"></td> </tr> <tr> <td align="left">Country:<br> <input type="text" name="[Custom]" size="20" maxlength="50"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="20" maxlength="20"></td> </tr> <tr> <td align="left">Fax Number:<br> <input type="text" name="Fax" size="20" maxlength="20"></td> </tr> <tr> <td> <input type="checkbox" name="MailingList" value="yes"> Add me to your mailing list</td> </tr> <tr> <td align="left">Comments:<br> <textarea name="Comments" rows="20" cols="50"></textarea></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> </td> </tr></table></body>