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</td> </tr> <tr> <td colspan="4" class="celltextBOLD"> Special Instructions: </td> </tr> <tr> <td colspan="4" class="celltextBOLD"> </td> </tr> <tr> <td colspan="4" class="celltext"> All personal information will be kept confidential </td> </tr> <tr> <td colspan="4" class="celltext"> * By submitting this form with your telephone number you are consenting for John Gee and all authorized representatives to contact you even if your name is on the <a href="https://www.donotcall.gov/default.aspx" target="_new">Federal Do-Not-Call List</a> </td> </tr> <tr class="celltextcolor"> <td colspan="4" class="celltext"> <table width="60%" border="0" align="center" cellpadding="3" cellspacing="0"> <tr> <td width="50%"> </td> <td width="50%"> </td> </tr> </table> </td> </tr> <tr class="celltextcolor"> <td colspan="4" class="celltext"> <table width="15%" border="0" align="center" cellpadding="3" cellspacing="0"> <tr> <td width="21%"> </td> <td width="79%"> <a tabindex="13" onclick="self.status='';return true;" onmouseover="self.status='Click to reset form';return true;" onmouseout="self.status='';return true;" href="javascript:form1.reset()"> <img src="images/reset.gif" border="0"></a> </td> </tr> </table> </td> </tr> <tr> <td colspan="4" class="celltext" height="100%" valign="top"> <table width="100%" border="0" align="center" cellpadding="3" cellspacing="0"> <tr> <td colspan="4" class="text" align="right" height="100%" valign="top"> &nbsp; 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