yamform test: Widget Request Form

Widget Services supplies widgets only to registered students, faculty and staff of Foobar University. To pick up your widget go to Room 101 between the hours of 1-2 pm Monday through Wednesday.


E-mail address:  (Complete address, e.g. "jdoe@foo.edu"!)

Name: 

Department: 

Phone: 


Favorite web page title: 

Favorite web page URL: 

Widget shape:

Widget color: Blue Yellow Red

Widget options: Pinstriping Turbo DeLuxe

What additional features would you like to see in a widget?

Select to submit your request.
Select to erase everything in the form.