Request More Info

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=48 BGCOLOR="#006633" TEXT="#F7F7FF" bgproperties="fixed" background="0542d353.gif"> <div>  Request More Info</div> <div> </div> </td> </tr><tr> <td valign="top" width=185 BGCOLOR="#BBBBBB" TEXT="#080000" bgproperties="fixed" background="055ba253.gif"> <div> <A HREF="id2.htm" TARGET="_top" TITLE="Trips"><U><B><IMG SRC="03417140.gif" border=0 width="23" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A><B>   </B><A HREF="id60.htm" TARGET="_top" TITLE="Directions and Forms "><U><B><IMG SRC="03517140.gif" border=0 width="23" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A><B>     </B><A HREF="index.htm" TARGET="_top" TITLE="CAMP PINEHURST"><U><B><IMG SRC="03617140.gif" border=0 width="23" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <A HREF="index.htm" TARGET="_top" TITLE="CAMP PINEHURST"><U>Home</U></A></div> <div> <A HREF="id9.htm" TARGET="_top" TITLE="Sessions and Prices for 2008"><U>Sessions and Prices for 2008</U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Map and Tour"><U>Map and Tour</U></A></div> <div> <A HREF="id7.htm" TARGET="_top" TITLE="Meet the Directors"><U>Meet the Directors</U></A></div> <div> <A HREF="id6.htm" TARGET="_top" TITLE="Cabins and Facilities"><U>Cabins and Facilities</U></A></div> <div> <A HREF="id4.htm" TARGET="_top" TITLE="Land Sports"><U>Land Sports</U></A></div> <div> <A HREF="id5.htm" TARGET="_top" TITLE="Waterfront Activities"><U>Waterfront Activities</U></A></div> <div> <A HREF="id2.htm" TARGET="_top" TITLE="Trips"><U>Trips</U></A></div> <div> <B> Request More Info</B></div> <div> <A HREF="id60.htm" TARGET="_top" TITLE="Directions and Forms "><U>Directions and Forms </U></A></div> <div> <A HREF="id114.htm" TARGET="_top" TITLE="Guestbook"><U>Guestbook</U></A></div> <div> <A HREF="id58.htm" TARGET="_top" TITLE="Packing List"><U>Packing List</U></A></div> <div> <A HREF="id8.htm" TARGET="_top" TITLE="Parent Camper Mailbag"><U>Parent Camper Mailbag</U></A></div> <div> <A HREF="id118.htm" TARGET="_top" TITLE="Slideshow"><U>Slideshow</U></A></div> <div> <A HREF="id124.htm" TARGET="_top" TITLE=" Alumni Message Board"><U> Alumni Message Board</U></A></div> </td> <td valign="top" height=432 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <B>Camp Pinehurst</B></div> <div> <B>Please contact me with more information about Camp Pinehurst</B></div> <FORM METHOD="POST" ACTION="http://www.response-o-matic.com/cgi-bin/rom.pl"> <INPUT TYPE=HIDDEN NAME="your_email_address"VALUE="director@camppinehurst.com"><P> <CENTER> <TABLE> <TR> <TD><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Name</TD> <TD COLSPAN=3 ALIGN=LEFT><input type="text" name="name" size=40></TD> </TR> <TR> <TD ALIGN=LEFT><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Camper's Name</TD> <TD><input type="text" name="camper" size=20></TD> </TR> <TR> <TD><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Age</TD> <TD><INPUT TYPE="text" NAME="age" size=6></TD> <TD><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Boy or Girl</TD> <TD><INPUT TYPE="text" NAME="boy or girl" size=15></TD> </TR> <TR> <TD>Email</TD> <TD COLSPAN=3 ALIGN=LEFT><input type="text" name="email" size=40></TD> </TR> <TR> <TD><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Street</TD> <TD COLSPAN=3 ALIGN=LEFT><input type="text" name="street" size=40></TD> </TR> <TR> <TD ALIGN=LEFT><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> City</TD> <TD><input type="text" name="city" size=15></TD> <TD><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> State</TD> <TD><INPUT TYPE="text" NAME="state" size=2></TD> </TR> <TR> <TD><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Zip Code</TD> <TD><input type="text" name="zip" size=9 maxlength="9"></TD> <TD>Country</TD> <TD><input type="text" name="country" vvalue="USA" size=10></TD> </TR> <TR> <TD><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">Phone</TD> <TD COLSPAN=3 ALIGN=LEFT><input type="text" name="phone" size=40></TD> </TR> <TR> <TD>Comments or How did you find us?</TD> <TD COLSPAN=3><TEXTAREA NAME="comments" ROWS="5" COLS="40"></TEXTAREA></TD> </TR> </TABLE> <P> <bR> <IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> <I>We need this to process your request!</I> <bR> </CENTER> <P> <CENTER> <INPUT TYPE="submit" NAME="submit" VALUE="Submit"> <INPUT TYPE="reset" NAME="reset" VALUE="Reset form"> </CENTER> </FORM> <CENTER> <I>If you leave an email address you will receive an email confirmation of this request.</I> <bR> <TABLE CELLSPACING="2" CELLPADDING="10" ALIGN=CENTER> <TR><TD> <ADDRESS> Camp Pinehurst<BR> 23 Curtis Road<BR> Raymond, ME<BR> 04071<BR> (207) 627-4670 (Summer)<BR> (203) 255-2364 (Fax)<BR> </ADDRESS> </TD> <TD> <ADDRESS> Camp Pinehurst<BR> 12 Cider Lane<BR> Nashua, NH<BR> 03063<BR> (603) 880-6287 (Winter)<BR> (603) 880-6287 (Fax)<BR> </ADDRESS> </TD> <TD ALIGN=CENTER> <ADDRESS> <A HREF="MAILTO:director@camppinehurst.com">director@camppinehurst.com</A> </ADDRESS> </TD> </TR> </TABLE> </CENTER> <bR> <bR> <bR> <bR> </td> </tr></table></body>