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<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=3 height=90 BGCOLOR="#006699" TEXT="#080000" background="06d085c3.jpg"> <div> <B>The Gestalt Counseling  And Training Institute of Ann Arbor</B></div> <div> <B>Holistic Therapy For Mind, Body and Spirit</B></div> <div> <B>    </B></div> <div> </div> </td> </tr><tr> <td valign="top" rowspan="2" width=210 BGCOLOR="#777777" TEXT="#080000" background="06fd2e83.jpg"> <div> <B><IMG SRC="12dc6870.jpg" border=0 width="198" height="135" ALIGN="BOTTOM" HSPACE="0" VSPACE="2"></B></div> <bR> <bR> <bR> <bR> <div>  <script type="text/javascript"> var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); </script> <script type="text/javascript"> try { var pageTracker = _gat._getTracker("UA-3330228-2"); pageTracker._trackPageview(); } catch(err) {}</script>  </div> </td> <td valign="top" height=315 colspan=2 BGCOLOR="#EEEEEE" TEXT="#080000"> <div> <I>Join Our Mailing List</I></div> <bR> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div>  <form action="http://csbmail.globalscape.com/cgi-bin/csbmail/csbmail.pl" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="FirstName,LastName,Email,Company,Address1,Address2,City,State,Zip,Phone,MailingList,Comments"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thank you for joining our Gestalt community!"><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="Someone joined your mailing list!"><input type="hidden" name="tlx_EmailTo" value="info@gestalt-annarbor.org"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">First Name:<br> <input type="text" name="FirstName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Last Name:<br> <input type="text" name="LastName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Company:<br> <input type="text" name="Company" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 1:<br> <input type="text" name="Address1" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 2:<br> <input type="text" name="Address2" size="30" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Zip:<br> <input type="text" name="Zip" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td> <input type="checkbox" name="MailingList" value="yes"> Add me to your mailing list</td> </tr> <tr> <td align="left">Comments:<br> <textarea name="Comments" rows="5" cols="30"></textarea></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> </td> </tr><tr> <td valign="top" colspan=2 height=75 BGCOLOR="#336666" TEXT="#080000" bgproperties="fixed" background="06e005c0dkdyad.jpg"> <div> <FONT SIZE="2" COLOR="#FFFFCC" FACE="Calibri" ><B>| </B><B>   </B></FONT><B> </B><A HREF="index.htm" TARGET="_top" TITLE="Gestalt Institute of Ann Arbor"><U><B>Home</B></U></A><B>     </B><A HREF="mission.htm" TARGET="_top" TITLE="Mission"><U><B>Mission</B></U></A><B>   |   </B><A HREF="therapy.htm" TARGET="_top" TITLE="Mind and Body Therapies"><U><B>Mind and Body Therapies</B></U></A><B>   |   </B><A HREF="training.htm" TARGET="_top" TITLE="Training in Gestalt Therapy"><U><B>Training in Gestalt Therapy</B></U></A><B>   |   </B><A HREF="staff.htm" TARGET="_top" TITLE="Professional Staff"><U><B>Professional Staff</B></U></A><B>   |   </B><A HREF="e_therapy.htm" TARGET="_top" TITLE="ETherapy!"><U><B>E-Therapy!</B></U></A><B>   |   </B><A HREF="calendar.htm" TARGET="_top" TITLE="Calendar"><U><B>Calendar</B></U></A><B>   |   </B><A HREF="contact.htm" TARGET="_top" TITLE="Contact Us"><U><B>Contact Us</B></U></A><B>   |   </B><A HREF="directions.htm" TARGET="_top" TITLE="Map and Directions"><U><B>Map and Directions</B></U></A><B>   |   </B><A HREF="fees.htm" TARGET="_top" TITLE="Reimbursement Schedule"><U><B>Reimbursement Schedule</B></U></A><B>   |   </B><A HREF="resources.htm" TARGET="_top" TITLE="Gestalt Links"><U><B>Gestalt Links</B></U></A><B>   |   </B><B>Join Our Mailing List</B><B>   |   </B><A HREF="gestalt_therapy.htm" TARGET="_top" TITLE="About Gestalt Therapy"><U><B>About Gestalt Therapy</B></U></A></div> <bR> </td> </tr></table></body>