"Name: ", $cgi->textfield( -name => 'NAME' ), "<BR>",
"Email: ", $cgi->textfield( -name => 'EMAIL' ), "<BR>",
"Affiliation: ", $cgi->textfield( -name => 'AFFILIATION' ), "<BR>",
"Name: ", $cgi->textfield( -name => 'NAME' ), "<BR>",
"Email: ", $cgi->textfield( -name => 'EMAIL' ), "<BR>",
"Affiliation: ", $cgi->textfield( -name => 'AFFILIATION' ), "<BR>",