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                    <h1><a href="/"><span>onlincolnshire supporting ICT innovation</span><img src="/images/h1-logo.gif" id="printlogo" alt="On Lincolnshire"/></a></h1>
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											<input type="radio" checked="checked" name="reg" id="reg-res" value="resident" />
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											<label for="reg-res"><strong>I am a Resident</strong></label>
											<p>I want to know about campaign updates and services in my area.</p>
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											<input type="radio" name="reg" id="reg-bus" value="business" />
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											<label for="reg-bus"><strong>Business</strong></label>
											<p>I want to know about campaign updates, services in my area, business support &amp; funding activity.</p>
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											<input type="radio" name="reg" id="reg-com" value="community" />
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										<label for="reg-com"><strong>Community</strong></label>
										<p>I want to publicise my campaign and know about services and activities in my area.</p>
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                <ul class="menu1"><li><a href="/home">Home</a></li><li class = " first"><a href="/Broadband-in-Lincolnshire">Broadband in Lincolnshire</a></li><li class = " childselectedl1  hasChildren"><a href="/How-we-can-help">How we can help</a></li><li class = "  hasChildren"><a href="/Getting-involved">Getting involved</a></li><li><a href="/Case-Studies">Case Studies</a></li><li class = "  hasChildren"><a href="/News/Project-News">News</a></li><li><a href="/Links">Links</a></li><li class = "  hasChildren"><a href="/About-us">About us</a></li><li class = "  hasChildren last"><a href="/Forum">Forum</a></li></ul>

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    <ul class="menu2"><li class = "  hasChildren first"><a href="/How-we-can-help/Residents">Residents</a></li><li class = " childselectedl2  hasChildren"><a href="/How-we-can-help/Businesses">Businesses</a><ul class="menu3"><li class = "  hasChildren first"><a href="/How-we-can-help/Businesses/Self-Help-Guides">Self Help Guides</a></li><li class = "  selectedl3  hasChildren"><a href="/How-we-can-help/Businesses/Register">Register</a></li><li><a href="/How-we-can-help/Businesses/Case-Studies"><span class="hide">Business </span>Case Studies</a></li><li class = " last"><a href="/How-we-can-help/Businesses/Digital-Business-Clusters">Digital Business Clusters</a></li></ul></li><li class = "  hasChildren"><a href="/How-we-can-help/Communities">Communities</a></li><li><a href="/How-we-can-help/Suppliers">Suppliers</a></li><li><a href="/How-we-can-help/Frequently-Asked-Questions">Frequently Asked Questions</a></li><li class = " last"><a href="/How-we-can-help/Jargon-Busters">Jargon Busters</a></li></ul>                         
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    <p><strong>Why should you complete our &lsquo;Broadband Demand Registration?'</strong></p>
<p>Less than 5 minutes of your time could help make a big difference...</p>
<p>The goal of onlincolnshire is to encourage commercial suppliers to invest in infrastructure in Lincolnshire.</p>
<p>Busineses in Lincolnshire are encouraged to register your interest in receiving improved broadband connectivity, whilst confirming your current connectivity speeds.</p>
<p>Please complete the following form.</p>
<p>Your registration will allow access to our online forums and you can opt in to receive our latest E-Newsletter.</p>
<p><strong>My personal Data</strong></p>
<p>I understand that by submitting my personal details including my phone number, this will assist Lincolnshire County Council in being able to identify broadband issues. I understand that my data will be used in a collective form to identify areas with poor connectivity and not as a means to offer individual advice. I have read and accept the Terms and Conditions of this site.</p>
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            <input type="hidden" name="formsubmit" value="1" />
            
            
            <div id="termsandconditions">
                <p>Lincolnshire County Council will use the details provided on this form to illustrate Lincolnshire's current level of connectivity, through the publication of maps and through collective data. Your personal contact details will be used by Lincolnshire County Council to contact you should we need to obtain further information from you about this or other requested services. All personal information will be processed in accordance with the Data Protection Act 1998 and you have the right to see records relating to yourself and to ask that they be amended where they are inaccurate.</p>
                    <p>Please select one of the options *</p>
                <div class="termbutton">
                    <input type="radio" name="termsandconditions" id="termsandconditions1" value="1" /><label for="termsandconditions1"> I agree to the <a href="/terms.html" title="terms and conditions" onclick="return popup(this,'terms')" onkeypress="return popup(this,'terms')">Terms and Conditions</a> and to the retention of my personal details by LCC as outlined above</label><br />
                </div>
                <div class="termbutton">
                    <input type="radio" name="termsandconditions" id="termsandconditions2" value="2" /><label for="termsandconditions2"> I agree to the <a href="/terms.html" title="terms and conditions" onclick="return popup(this,'terms')" onkeypress="return popup(this,'terms')">Terms and Conditions</a>, but I do not agree to the use of my personal details by LCC other than for the processing of my broadband service details</label><br />
                </div>
                <div class="termbutton">
                    <input type="radio" name="termsandconditions" id="termsandconditions3" value="3" /><label for="termsandconditions3"> I do not agree to the <a href="/terms.html" title="terms and conditions" onclick="return popup(this,'terms')" onkeypress="return popup(this,'terms')">Terms and Conditions</a></label>.
                </div>
            </div>
            <div id="register-left">
            <span class="heading">Your identity</span>
<!-- title -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="title">
                            Title</label></div>
                    <div class="reg-right">
                        <select id="title" name="title" class="selecta">                   
                            	<option value="0" selected="selected">Select</option>
	                            <option value="5">Mr</option>
	                            <option value="2">Mrs</option>
	                            <option value="3">Miss</option>
	                            <option value="4">Ms</option>
	                            <option value="74">Dr</option>
	                            <option value="75">Rev</option>
	                            <option value="76">Cllr</option>
                        </select>
                            
                            </div>
                    <div class="clear">
                    </div>
                </div>
<!-- FIRST NAME -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="fname">
                            First name</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="fname" name="fname" maxlength="100" value="First name"
                            onfocus="clearme(this,'First name');" /></div>
                    <div class="clear">
                    </div>
                </div>
<!-- SURNAME -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="sname">
                            Surname</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="sname" name="sname" maxlength="50" value="Surname"
                            onfocus="clearme(this,'Surname');" /></div>
                    <div class="clear">
                    </div>
                </div>
                
<!-- TELEPHONE -->                
                <div class="formquestion">
                    <div class="label req">
                        <label for="telephone">
                            Telephone</label>
						<br />
                        <em>Fixed line only, excluding the area code</em>        
                    </div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="telephone" name="telephone" maxlength="7" value="123456"
                            onfocus="clearme(this,'123456');" /></div>
                    <div class="clear">
                    </div>
                </div>
                
<!-- JOB TITLE -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="job">
                            Job description</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="job" name="job" maxlength="100" value="Job description"
                            onfocus="clearme(this,'Job description');" /></div>
                    <div class="clear">
                    </div>
                </div>
                
                
                <span class="heading">Your Account Details</span>
<!-- EMAIL -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="email">
                            Email Address</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="email" name="email" maxlength="100" value="Email"
                            onfocus="clearme(this,'Email');" /></div>
                    <div class="clear">
                    </div>
                </div>
<!-- PASSWORD -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="regpassword">
                            Password</label><br />
                        <em>Your password must be alphanumeric and a minimum of 5-10 characters, cannot be "password"</em>
                    </div>
                    <div class="reg-right">
                        <input class="textinput" type="password" id="regpassword" name="regpassword" maxlength="20" value="password" onfocus="clearme(this,'password');" /></div>
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                    </div>
                </div>
<!-- PASSWORD CONFIRM -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="passwordconfirm">
                            Confirm password</label><br />
                        <em>Please confirm your chosen password</em>
                    </div>
                    <div class="reg-right">
                        <input class="textinput" type="password" id="passwordconfirm" name="passwordconfirm" maxlength="20" value="password" onfocus="clearme(this,'password');" /></div>
                    <div class="clear">
                    </div>
                </div>

                <span class="heading">Your Business Information</span>
                
                <!-- COMPANY -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="company">
                            Company name</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="company" name="company" maxlength="100"
                            value="Company name" onfocus="clearme(this,'Company name');" /></div>
                    <div class="clear">
                    </div>
                </div>
<!-- ADDRESS 1 -->
                 <div class="formquestion">
                    <div class="label req">
                        <label for="address1">
                            Address Line 1</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="address1" name="address1" maxlength="100"
                            value="Address line 1" onfocus="clearme(this,'Address line 1');" /></div>
                    <div class="clear">
                    </div>
                </div>
<!-- ADDRESS 2 -->
                 <div class="formquestion">
                    <div class="label">
                        <label for="address2">
                            Address Line 2</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="address2" name="address2" maxlength="100"
                            value="Address line 2" onfocus="clearme(this,'Address line 2');" /></div>
                    <div class="clear">
                    </div>
                </div>
<!-- ADDRESS 3 -->
                 <div class="formquestion">
                    <div class="label">
                        <label for="address3">
                            Address Line 3</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="address3" name="address3" maxlength="100"
                            value="Address line 3" onfocus="clearme(this,'Address line 3');" /></div>
                    <div class="clear">
                    </div>
                </div>
<!-- TOWN/CITY -->
                 <div class="formquestion">
                    <div class="label req">
                        <label for="city">
                            Town/City</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="city" name="city" maxlength="100" value="Town/City"
                            onfocus="clearme(this,'Town/City');" /></div>
                    <div class="clear">
                    </div>
                </div>
<!-- BUSINESS POSTCODE -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="buspostcode">
                            Postcode</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="buspostcode" name="buspostcode" maxlength="20" value="Business Postcode"
                            onfocus="clearme(this,'Business Postcode');" /></div>
                    <div class="clear">
                    </div>
                </div>
<!-- WEBSITE -->
                <div class="formquestion">
                    <div class="label">
                        <label for="website">
                            Website address</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="website" name="website" maxlength="80" value="Website"
                            onfocus="clearme(this,'Website');" /></div>
                    <div class="clear">
                    </div>
                </div>
<!-- BUSINESS SIZE -->
                <div class="formquestion">
                    <div class="label">
                        Business Size / Employee Range</div>
                    <div class="reg-right">
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="businesssize" id="businesssize1" value="1" /></div><div class="option-right"><label for="businesssize1">1 &ndash; 9 Employees.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">   
                            <input type="radio" name="businesssize" id="businesssize2" value="2" /></div><div class="option-right"><label for="businesssize2">10 &ndash;  250 Employees.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left"> 
                        <input type="radio" name="businesssize" id="businesssize3" value="3" /></div><div class="option-right"><label for="businesssize3">Over 250 Employees.</label></div>
                        <div class="clear"></div>
                        </div>
                    </div>
                    <div class="clear">
                    </div>
                </div>
<!-- NATURE OF BUSINESS -->
                 <div class="formquestion">
                    <div class="label">
                        <label for="businessnature">
                            Nature of Business</label></div>
                    <div class="reg-right">
                        <select id="businessnature" name="businessnature" class="selecta">                
                            	<option value="0" selected="selected">Select</option>
	                            <option value="1">Added Value Engineering</option>
	                            <option value="2">Advanced Materials</option>
	                            <option value="3">Aerospace</option>
	                            <option value="4">Agriculture, Forestry and Fishing</option>
	                            <option value="5">Automotive</option>
	                            <option value="6">Biotechnology / Pharmaceuticals</option>
	                            <option value="7">Business Services</option>
	                            <option value="8">Chemicals</option>
	                            <option value="9">Community and Voluntary</option>
	                            <option value="10">Computer Hardware and Software</option>
	                            <option value="11">Construction and Construction Products</option>
	                            <option value="12">Creative Industries</option>
	                            <option value="13">Education</option>
	                            <option value="14">Electronics and Electrical</option>
	                            <option value="15">Environmental Technology</option>
	                            <option value="16">Financial Services</option>
	                            <option value="17">Food &amp; Drink</option>
	                            <option value="18">Furniture</option>
	                            <option value="19">General Engineering</option>
	                            <option value="20">Health &amp; Social Work</option>
	                            <option value="21">Leisure and Tourism</option>
	                            <option value="22">Logistics &amp; Distribution</option>
	                            <option value="23">Low Carbon Technology</option>
	                            <option value="24">Marine</option>
	                            <option value="25">Medical Devices</option>
	                            <option value="26">Mining and Quarrying</option>
	                            <option value="27">Misc. Fabricated Products</option>
	                            <option value="28">Motor Sport</option>
	                            <option value="29">Other</option>
	                            <option value="30">Outsourcing</option>
	                            <option value="31">Paper Products and Packaging</option>
	                            <option value="32">Photonics</option>
	                            <option value="33">Property Agent</option>
	                            <option value="34">Publics Services, Admin and Defence</option>
	                            <option value="35">Publishing and Printing</option>
	                            <option value="36">Rail</option>
	                            <option value="37">Renewable Energy</option>
	                            <option value="38">Retail</option>
	                            <option value="39">Rubber &amp; Plastics</option>
	                            <option value="40">Telecommunications</option>
	                            <option value="41">Telematics</option>
	                            <option value="42">Unknown</option>
	                            <option value="43">Waste Management</option>
                        </select>
                    </div>
                    <div class="clear">
                    </div>
                </div>

                <span class="heading">Your Broadband Service Experience</span>
                

<!-- POSTCODE -->
                <!--<div class="formquestion">
                    <div class="label">
                        <label for="postcode">
                            What is your Postcode at your Business Location?</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="postcode" name="postcode" maxlength="100"
                            value="Postcode" onfocus="clearme(this,'Postcode');" /></div>
                    <div class="clear">
                    </div>
                </div>-->
<!-- IS BB AVAILABLE IN YOUR AREA? -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="bbavailable">
                            Can you receive Broadband at your Business location?</label></div>
                    <div class="reg-right">
                        <select id="bbavailable" name="bbavailable" class="selecta">
                            <option value="0" selected="selected">Select</option>
                            <option value="14">Yes</option>
                            <option value="15">No</option>
                        </select>
                    </div>
                    <div class="clear">
                    </div>
                </div>
<!-- HOW FAST IS IT? -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="bbspeed">
                            What Broadband Speeds are you Receiving?</label>
                            <a href="/links.html" onclick="return popup(this,'links');" onkeypress="return popup(this,'links');">Help</a>                            
                            </div>
                    <div class="reg-right">
                        <select id="bbspeed" name="bbspeed" class="selecta">
                            <option value="0" selected="selected">Select</option>
							<option value="174">No Broadband - Use dial up</option>
							<option value="175">Less than 512 Kbps</option>
							<option value="176">512 Kbps to 1 Mbps</option>
							<option value="177">1 Mbps to 2 Mbps</option>
							<option value="178">2 Mbps to 10 Mbps</option>
							<option value="179">10 Mbps to 20 Mbps</option>
							<option value="180">Greater than 20 Mbps</option>
							<option value="181">Don't know</option>
							
							
							<!--<option value="0" selected="selected">Select</option>
                            <option value="16">No Broadband &ndash; Use dial up</option>
                            <option value="17">Less than 512 Kbps</option>
                            <option value="18">512 Kbps to 1 Mbps</option>
                            <option value="20">1 Mbps to 2 Mbps</option>
                            <option value="21">Greater than 2 Mbps</option>
                            <option value="22">Don't Know</option>-->
                        </select></div>
                    <div class="clear">
                    </div>
                </div>
               <div id="extralinks">
                     
                </div>
<!-- SPEED AFFECT -->
                <div class="formquestion">
                    <div class="label req">
                        
                            How does the Broadband Speed you receive affect your daily tasks at your location?</div>
                    <div class="reg-right">
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect" id="bbspeedaffect1" value="23" /></div><div class="option-right"><label for="bbspeedaffect1">I can work efficiently with my current Broadband Service.</label></div>
                            <div class="clear"></div>
                            </div>
                            <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect" id="bbspeedaffect2" value="24" /></div><div class="option-right"><label for="bbspeedaffect2">I have a very slow service, so I can only complete some of my daily tasks.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect" id="bbspeedaffect3" value="25" /></div><div class="option-right"><label for="bbspeedaffect3">It does not affect me. My Business does not use the internet.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect" id="bbspeedaffect4" value="26" /></div><div class="option-right"><label for="bbspeedaffect4">I can not carry out any tasks, due to the lack of Broadband at my location.</label></div>
                        <div class="clear"></div>
                        </div>
                    </div>
                    <div class="clear">
                    </div>
                </div>
<!-- SPEED IMPORTANCE -->
                <div class="formquestion">
                    <div class="label req">
                        <label for="bbspeedimportance">
                            How Important is fast Broadband Connection to the future of your business?</label></div>
                    <div class="reg-right">
                        <select id="bbspeedimportance" name="bbspeedimportance" class="selecta">
                            <option value="0" selected="selected">Select</option>
                            <option value="27">Very Important</option>
                            <option value="29">Quite Important</option>
                            <option value="30">Not Very Important</option>
                            <option value="31">Not Important</option>
                        </select></div>
                    <div class="clear">
                    </div>
                </div>

<!-- EXTRA FORM STUFF FOR SLIDER! -->
                
<!-- MORE THAN ONE BUSINESS? -->
<div class="regdropholder">
           
                            
                
          
                
               

<div id="extra-locations">
	<div class="extra-location" id="el2">
	<span class="heading">Business Location Two</span>
		<!-- BUSINESS POSTCODE -->
                <div class="formquestion">
                    <div class="label">
                        <label for="buspostcode2">
                            Postcode</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="buspostcode2" name="buspostcode2" maxlength="20" value="Business Postcode"
                            onfocus="clearme(this,'Business Postcode');" /></div>
                    <div class="clear">
                    </div>
                </div>
        <!-- TELEPHONE -->                
                <div class="formquestion">
                    <div class="label">
                        <label for="telephone2">
                            Telephone</label>
						<br />
                        <em>Fixed line only, excluding the area code</em>        
                    </div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="telephone2" name="telephone2" maxlength="7" value="123456"
                            onfocus="clearme(this,'123456');" /></div>
                    <div class="clear">
                    </div>
                </div>
		<!-- IS BB AVAILABLE IN YOUR AREA? -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbavailable2">
                            Can you receive Broadband at your Business location?</label></div>
                    <div class="reg-right">
                        <select id="bbavailable2" name="bbavailable2" class="selecta">
                            <option value="0" selected="selected">Select</option>
                            <option value="14">Yes</option>
                            <option value="15">No</option>
                        </select>
                    </div>
                    <div class="clear">
                    </div>
                </div>
		<!-- HOW FAST IS IT? -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbspeed2">
                            What Broadband Speeds are you Receiving?</label>
                            <a href="/links.html" onclick="return popup(this,'links');" onkeypress="return popup(this,'links');">Help</a>
                            </div>
                    <div class="reg-right">
                        <select id="bbspeed2" name="bbspeed2" class="selecta">
                            <option value="0" selected="selected">Select</option>
							<option value="174">No Broadband - Use dial up</option>
							<option value="175">Less than 512 Kbps</option>
							<option value="176">512 Kbps to 1 Mbps</option>
							<option value="177">1 Mbps to 2 Mbps</option>
							<option value="178">2 Mbps to 10 Mbps</option>
							<option value="179">10 Mbps to 20 Mbps</option>
							<option value="180">Greater than 20 Mbps</option>
							<option value="181">Don't know</option>
                        </select></div>
                    <div class="clear">
                    </div>
                </div>
		<!-- SPEED AFFECT -->
                <div class="formquestion">
                    <div class="label">
                            How does the Broadband Speed you receive affect your daily tasks at your location?</div>
                    <div class="reg-right">
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect2" id="bbspeedaffect2-1" value="23" /></div><div class="option-right"><label for="bbspeedaffect2-1">I can work efficiently with my current Broadband Service.</label></div>
                            <div class="clear"></div>
                            </div>
                            <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect2" id="bbspeedaffect2-2" value="24" /></div><div class="option-right"><label for="bbspeedaffect2-2">I have a very slow service, so I can only complete some of my daily tasks.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect2" id="bbspeedaffect2-3" value="25" /></div><div class="option-right"><label for="bbspeedaffect2-3">It does not affect me. My Business does not use the internet.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect2" id="bbspeedaffect2-4" value="26" /></div><div class="option-right"><label for="bbspeedaffect2-4">I can not carry out any tasks, due to the lack of Broadband at my location.</label></div>
                        <div class="clear"></div>
                        </div>
                    </div>
                    <div class="clear">
                    </div>
                </div>
		<!-- SPEED IMPORTANCE -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbspeedimportance2">
                            How Important is fast Broadband Connection to the future of your business?</label></div>
                    <div class="reg-right">
                        <select id="bbspeedimportance2" name="bbspeedimportance2" class="selecta">
                            <option value="0" selected="selected">Select</option>
                            <option value="27">Very Important</option>
                            <option value="29">Quite Important</option>
                            <option value="30">Not Very Important</option>
                            <option value="31">Not Important</option>
                        </select></div>
                    <div class="clear">
                    </div>
                </div>
	</div> <!-- close #el2 -->

	<div class="extra-location" id="el3">
	<span class="heading">Business Location Three</span>
		<!-- BUSINESS POSTCODE -->
						<div class="formquestion">
                    <div class="label">
                        <label for="buspostcode3">
                            Postcode</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="buspostcode3" name="buspostcode3" maxlength="20" value="Business Postcode"
                            onfocus="clearme(this,'Business Postcode');" /></div>
                    <div class="clear">
                    </div>
                </div>
        <!-- TELEPHONE -->                
                <div class="formquestion">
                    <div class="label">
                        <label for="telephone3">
                            Telephone</label>
						<br />
                        <em>Fixed line only, excluding the area code</em>        
                    </div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="telephone3" name="telephone3" maxlength="7" value="123456"
                            onfocus="clearme(this,'123456');" /></div>
                    <div class="clear">
                    </div>
                </div>
		<!-- IS BB AVAILABLE IN YOUR AREA? -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbavailable3">
                            Can you receive Broadband at your Business location?</label></div>
                    <div class="reg-right">
                        <select id="bbavailable3" name="bbavailable3" class="selecta">
                            <option value="0" selected="selected">Select</option>
                            <option value="14">Yes</option>
                            <option value="15">No</option>
                        </select>
                    </div>
                    <div class="clear">
                    </div>
                </div>
		<!-- HOW FAST IS IT? -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbspeed3">
                            What Broadband Speeds are you Receiving?</label>
                            <a href="/links.html" onclick="return popup(this,'links');" onkeypress="return popup(this,'links');">Help</a>
                            </div>
                    <div class="reg-right">
                        <select id="bbspeed3" name="bbspeed3" class="selecta">
                            <option value="0" selected="selected">Select</option>
							<option value="174">No Broadband - Use dial up</option>
							<option value="175">Less than 512 Kbps</option>
							<option value="176">512 Kbps to 1 Mbps</option>
							<option value="177">1 Mbps to 2 Mbps</option>
							<option value="178">2 Mbps to 10 Mbps</option>
							<option value="179">10 Mbps to 20 Mbps</option>
							<option value="180">Greater than 20 Mbps</option>
							<option value="181">Don't know</option>
                        </select></div>
                    <div class="clear">
                    </div>
                </div>
		<!-- SPEED AFFECT -->
                <div class="formquestion">
                    <div class="label">
                            How does the Broadband Speed you receive affect your daily tasks at your location?</div>
                    <div class="reg-right">
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect3" id="bbspeedaffect3-1" value="23" /></div><div class="option-right"><label for="bbspeedaffect3-1">I can work efficiently with my current Broadband Service.</label></div>
                            <div class="clear"></div>
                            </div>
                            <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect3" id="bbspeedaffect3-2" value="24" /></div><div class="option-right"><label for="bbspeedaffect3-2">I have a very slow service, so I can only complete some of my daily tasks.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect3" id="bbspeedaffect3-3" value="25" /></div><div class="option-right"><label for="bbspeedaffect3-3">It does not affect me. My Business does not use the internet.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect3" id="bbspeedaffect3-4" value="26" /></div><div class="option-right"><label for="bbspeedaffect3-4">I can not carry out any tasks, due to the lack of Broadband at my location.</label></div>
                        <div class="clear"></div>
                        </div>
                    </div>
                    <div class="clear">
                    </div>
                </div>
		<!-- SPEED IMPORTANCE -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbspeedimportance3">
                            How Important is fast Broadband Connection to the future of your business?</label></div>
                    <div class="reg-right">
                        <select id="bbspeedimportance3" name="bbspeedimportance3" class="selecta">
                            <option value="0" selected="selected">Select</option>
                            <option value="27">Very Important</option>
                            <option value="29">Quite Important</option>
                            <option value="30">Not Very Important</option>
                            <option value="31">Not Important</option>
                        </select></div>
                    <div class="clear">
                    </div>
                </div>
	</div> <!-- close #el3 -->

	<div class="extra-location" id="el4">
	<span class="heading">Business Location Four</span>
		<!-- BUSINESS POSTCODE -->
                <div class="formquestion">
                    <div class="label">
                        <label for="buspostcode4">
                            Postcode</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="buspostcode4" name="buspostcode4" maxlength="20" value="Business Postcode"
                            onfocus="clearme(this,'Business Postcode');" /></div>
                    <div class="clear">
                    </div>
                </div>
        <!-- TELEPHONE -->                
                <div class="formquestion">
                    <div class="label">
                        <label for="telephone4">
                            Telephone</label>
						<br />
                        <em>Fixed line only, excluding the area code</em>        
                    </div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="telephone4" name="telephone4" maxlength="7" value="123456"
                            onfocus="clearme(this,'123456');" /></div>
                    <div class="clear">
                    </div>
                </div>
		<!-- IS BB AVAILABLE IN YOUR AREA? -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbavailable4">
                            Can you receive Broadband at your Business location?</label></div>
                    <div class="reg-right">
                        <select id="bbavailable4" name="bbavailable4" class="selecta">
                            <option value="0" selected="selected">Select</option>
                            <option value="14">Yes</option>
                            <option value="15">No</option>
                        </select>
                    </div>
                    <div class="clear">
                    </div>
                </div>
		<!-- HOW FAST IS IT? -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbspeed4">
                            What Broadband Speeds are you Receiving?</label>
                            <a href="/links.html" onclick="return popup(this,'links');" onkeypress="return popup(this,'links');">Help</a>
                            </div>
                    <div class="reg-right">
                        <select id="bbspeed4" name="bbspeed4" class="selecta">
                            <option value="0" selected="selected">Select</option>
							<option value="174">No Broadband - Use dial up</option>
							<option value="175">Less than 512 Kbps</option>
							<option value="176">512 Kbps to 1 Mbps</option>
							<option value="177">1 Mbps to 2 Mbps</option>
							<option value="178">2 Mbps to 10 Mbps</option>
							<option value="179">10 Mbps to 20 Mbps</option>
							<option value="180">Greater than 20 Mbps</option>
							<option value="181">Don't know</option>
                        </select></div>
                    <div class="clear">
                    </div>
                </div>
		<!-- SPEED AFFECT -->
                <div class="formquestion">
                    <div class="label">
                            How does the Broadband Speed you receive affect your daily tasks at your location?</div>
                    <div class="reg-right">
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect4" id="bbspeedaffect4-1" value="23" /></div><div class="option-right"><label for="bbspeedaffect4-1">I can work efficiently with my current Broadband Service.</label></div>
                            <div class="clear"></div>
                            </div>
                            <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect4" id="bbspeedaffect4-2" value="24" /></div><div class="option-right"><label for="bbspeedaffect4-2">I have a very slow service, so I can only complete some of my daily tasks.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect4" id="bbspeedaffect4-3" value="25" /></div><div class="option-right"><label for="bbspeedaffect4-3">It does not affect me. My Business does not use the internet.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect4" id="bbspeedaffect4-4" value="26" /></div><div class="option-right"><label for="bbspeedaffect4-4">I can not carry out any tasks, due to the lack of Broadband at my location.</label></div>
                        <div class="clear"></div>
                        </div>
                    </div>
                    <div class="clear">
                    </div>
                </div>
		<!-- SPEED IMPORTANCE -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbspeedimportance4">
                            How Important is fast Broadband Connection to the future of your business?</label></div>
                    <div class="reg-right">
                        <select id="bbspeedimportance4" name="bbspeedimportance4" class="selecta">
                            <option value="0" selected="selected">Select</option>
							<option value="27">Very Important</option>
                            <option value="29">Quite Important</option>
                            <option value="30">Not Very Important</option>
                            <option value="31">Not Important</option>
                        </select></div>
                    <div class="clear">
                    </div>
                </div>
	</div> <!-- close #el4 -->
	
	<div class="extra-location" id="el5">
	<span class="heading">Business Location Five</span>
		<!-- BUSINESS POSTCODE -->
                <div class="formquestion">
                    <div class="label">
                        <label for="buspostcode5">
                            Postcode</label></div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="buspostcode5" name="buspostcode5" maxlength="20" value="Business Postcode"
                            onfocus="clearme(this,'Business Postcode');" /></div>
                    <div class="clear">
                    </div>
                </div>
        <!-- TELEPHONE -->                
                <div class="formquestion">
                    <div class="label">
                        <label for="telephone5">
                            Telephone</label>
						<br />
                        <em>Fixed line only, excluding the area code</em>        
                    </div>
                    <div class="reg-right">
                        <input class="textinput" type="text" id="telephone5" name="telephone5" maxlength="7" value="123456"
                            onfocus="clearme(this,'123456');" /></div>
                    <div class="clear">
                    </div>
                </div>
		<!-- IS BB AVAILABLE IN YOUR AREA? -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbavailable5">
                            Can you receive Broadband at your Business location?</label></div>
                    <div class="reg-right">
                        <select id="bbavailable5" name="bbavailable5" class="selecta">
                            <option value="0" selected="selected">Select</option>
                            <option value="14">Yes</option>
                            <option value="15">No</option>
                        </select>
                    </div>
                    <div class="clear">
                    </div>
                </div>
		<!-- HOW FAST IS IT? -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbspeed5">
                            What Broadband Speeds are you Receiving?</label>
                            <a href="/links.html" onclick="return popup(this,'links');" onkeypress="return popup(this,'links');">Help</a>
                            </div>
                    <div class="reg-right">
                        <select id="bbspeed5" name="bbspeed5" class="selecta">
                            <option value="0" selected="selected">Select</option>
							<option value="174">No Broadband - Use dial up</option>
							<option value="175">Less than 512 Kbps</option>
							<option value="176">512 Kbps to 1 Mbps</option>
							<option value="177">1 Mbps to 2 Mbps</option>
							<option value="178">2 Mbps to 10 Mbps</option>
							<option value="179">10 Mbps to 20 Mbps</option>
							<option value="180">Greater than 20 Mbps</option>
							<option value="181">Don't know</option>
                        </select></div>
                    <div class="clear">
                    </div>
                </div>
		<!-- SPEED AFFECT -->
                <div class="formquestion">
                    <div class="label">
                            How does the Broadband Speed you receive affect your daily tasks at your location?</div>
                    <div class="reg-right">
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect5" id="bbspeedaffect5-1" value="23" /></div><div class="option-right"><label for="bbspeedaffect5-1">I can work efficiently with my current Broadband Service.</label></div>
                            <div class="clear"></div>
                            </div>
                            <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect5" id="bbspeedaffect5-2" value="24" /></div><div class="option-right"><label for="bbspeedaffect5-2">I have a very slow service, so I can only complete some of my daily tasks.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect5" id="bbspeedaffect5-3" value="25" /></div><div class="option-right"><label for="bbspeedaffect5-3">It does not affect me. My Business does not use the internet.</label></div>
                        <div class="clear"></div>
                        </div>
                        <div class="option">
                            <div class="option-left">
                            <input type="radio" name="bbspeedaffect5" id="bbspeedaffect5-4" value="26" /></div><div class="option-right"><label for="bbspeedaffect5-4">I can not carry out any tasks, due to the lack of Broadband at my location.</label></div>
                        <div class="clear"></div>
                        </div>
                    </div>
                    <div class="clear">
                    </div>
                </div>
		<!-- SPEED IMPORTANCE -->
                <div class="formquestion">
                    <div class="label">
                        <label for="bbspeedimportance5">
                            How Important is fast Broadband Connection to the future of your business?</label></div>
                    <div class="reg-right">
                        <select id="bbspeedimportance5" name="bbspeedimportance5" class="selecta">
                            <option value="0" selected="selected">Select</option>
                            <option value="27">Very Important</option>
                            <option value="29">Quite Important</option>
                            <option value="30">Not Very Important</option>
                            <option value="31">Not Important</option>
                        </select></div>
                    <div class="clear">
                    </div>
                </div>
                </div>
   
   </div> <!-- close #el5 -->
   <div id="add-location">Click here to add another business location</div>
   <div class="clear"></div>                       
</div>         
      

                <span class="heading">Marketing</span>
<!-- HOW DID YOU HEAR? -->                
                <div class="formquestion">
                    <div class="label req">
                        
                            How Did you hear about Onlincolnshire?
                    </div>
                    <div class="reg-right">
                    <div class="option">
                        <div class="option-left">
                        <input type="radio" name="howdidyouhear" id="howdidyouhear1" value="1" /></div><div class="option-right"><label for="howdidyouhear1">County News / Local Newspaper / Local Radio</label></div>
                    <div class="clear"></div>
                    </div>
                    <div class="option">
                        <div class="option-left">
                        <input type="radio" name="howdidyouhear" id="howdidyouhear2" value="2" /></div><div class="option-right"><label for="howdidyouhear2">Email</label></div>
                    <div class="clear"></div>
                    </div>
                    <div class="option">
                        <div class="option-left">
                        <input type="radio" name="howdidyouhear" id="howdidyouhear3" value="3" /></div><div class="option-right"><label for="howdidyouhear3">Website</label></div>
                    <div class="clear"></div>
                    </div>
                    <div class="option">
                        <div class="option-left">
                        <input type="radio" name="howdidyouhear" id="howdidyouhear4" value="4" /></div><div class="option-right"><label for="howdidyouhear4">Word of Mouth</label></div>
                    <div class="clear"></div>
                    </div>
					<div class="option">
                        <div class="option-left">
                        <input type="radio" name="howdidyouhear" id="howdidyouhear5" value="5" /></div><div class="option-right"><label for="howdidyouhear5">Digital Business Clusters</label></div>
                    <div class="clear"></div>
                    </div>
                    </div>
                    <div class="clear">
                    </div>
                </div>
<!-- RECEIVE EMAIL -->
                <div class="formquestion">
                    <div class="label req" style="padding-top:0;">
                        <label for="receivemail">
                            I would like to receive the Onlincolnshire Newsletter</label>
                    </div>
                    <div class="reg-right">
                        <input type="radio" name="receivemail" checked="checked" id="receivemail" value="1" />
                        Yes &nbsp;&nbsp;&nbsp;
                        <input type="radio" name="receivemail" value="0" />
                        No
                    </div>
                    <div class="clear">
                    </div>
                </div>              
              
                <input id="submit" class="submit" type="image" alt="submit" src="/images/btn-submitreg.gif"
                    name="submit" value="submit" />
            </div>
<!-- RIGHT SIDE OF FORM -->
            <!--<div id="register-right">

            </div>-->
        </fieldset>
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