<TD width="10" class="bottom2 seperator"> </TD>
<TD class="bottom2"><INPUT type="text" name="reason"
class="member_normal" size="30" maxlength="255"
<TD width="10" class="bottom2 seperator"> </TD>
<TD class="bottom2"><INPUT type="text" name="reason"
class="member_normal" size="30" maxlength="255"