<html>
<head>
<title>Lost Password</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
</head>

<body bgcolor="#FFFFFF" text="#000000">
<div align="center">
  <table width="100%" cellspacing="0" cellpadding="0">
    <tr>
      <td><a href="/safelist.shtml"><img src="/images/Lifetime.gif" border="0" alt="Click Our Logo To Go To Safelist Home Page"></a></td>
    </tr>
  </table>
  <br>
  <font size="2" face="Verdana, Arial, Helvetica, sans-serif">Please enter your 
  Username and Birthdate <br>
  to have your password sent to you via your registered email address.</font><br>
  <br>
  <form method="post" action="main.cgi">
    <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Username: 
      <input type="text" name="user1" size="15">
      <br>
      Birthdate:  
      <input type="text" name="DOB1" size="15">
      </font> </p>
    <p> 
      <input type="submit" name="action" value="Get Password">
  </form>
  <p> </p><p> </p>
  <p><font face="Verdana, Arial, Helvetica, sans-serif" size="1"></font></p>
  <p>  </p>
</div>
</body>
</html>
