--- /dev/null
+<?PHP
+include_once('maryland_voter.php');
+if (isset($_POST['SearchFirstName'])){
+ $voter = md_voter_lookup($_POST['SearchFirstName'],$_POST['SearchLastName'],$_POST['DOBMonth'],$_POST['DOBDay'],$_POST['DOBYear'],$_POST['SearchZipCode'],$_POST['SearchHouseNumber'],$_POST['SearchMiddleInitial']);
+ echo $voter['html'];
+}
+?>
+ <form method='POST'>
+ <table>
+ <tr>
+ <td>SearchFirstName</td><td><input name='SearchFirstName'></td>
+ </tr>
+ <tr>
+ <td>SearchLastName</td><td><input name='SearchLastName'></td>
+ </tr>
+ <tr>
+ <td>DOBMonth</td><td><input name='DOBMonth'></td>
+ </tr>
+ <tr>
+ <td>DOBDay</td><td><input name='DOBDay'></td>
+ </tr>
+ <tr>
+ <td>DOBYear</td><td><input name='DOBYear'></td>
+ </tr>
+ <tr>
+ <td>SearchZipCode</td><td><input name='SearchZipCode'></td>
+ </tr>
+ <tr>
+ <td>SearchHouseNumber*</td><td><input name='SearchHouseNumber'></td>
+ </tr>
+ <tr>
+ <td>SearchMiddleInitial*</td><td><input name='SearchMiddleInitial'></td>
+ </tr>
+ <tr>
+ <td>*Optional</td><td><input type='submit'></td>
+ </tr>
+ </table>
+ </form>