;">
Last Name:<span style="color:red">*</span>
</span>
<input name="LastName" style="position:absolute; width:212px; height:16px; left:6px; top:82px;" type="text">
<span style="position:absolute; left:6px; top:115px; font-weight:bold;">
Phone Number:<span style="color:red">*</span>
</span>
<input name="PhoneNumber" style="position:absolute; width:211px; height:16px; left:6px; top:134px;" type="text">
<span style="position:absolute; left:6px; top:168px; font-weight:bold;">
Email Address:<span style="color:re