From: [required-from]
To: The Mayor via Gastown Security <gastown>
Subject: Request for [required-wanted]
X-secure: mayor

[urgency] ** WARNING: THIS MESSAGE SENT FROM A WEB-BROSWER CANNOT BE TRUSTED **

My operating system and connectivity is: [opersyst]
My primary web browser is: [browser]
Other platform/connection/browser info: [otherinfo]

I learned about Gastown Webspace from: [referral]

Full Name        : [fullname]
Organization     : [organization]
Location         : [location]
Alternate e-mail : [altemail]

Comments:
[comments]