<FORM name="mailform" ACTION="http://www.xy.com/cgi-bin/script.cgi" METHOD="post">
<INPUT TYPE="checkbox" NAME="chkbox1" VALUE="chkb1" CHECKED>Checkbox
Checkbox
<INPUT TYPE="text" VALUE="Text" NAME="text1" size=20>

<INPUT TYPE="submit" VALUE="Send">

<INPUT TYPE="reset" VALUE="Reset to default">

</FORM>