 <option>Utah</option>
                                  <option>Vermont</option>
                                  <option>Virginia</option>
                                  <option>Washington</option>
                                  <option>West   Virginia</option>
                                  <option>Wisconsin</option>
                                  <option>Wyoming</option>
                                  </select><input name="zip" size="20" value="zip" type="text">
              </p><p alig