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<form action='http://count.ariefsite.xtgem.com/get'>Counter Style:<select name='dd'><option value='A'>1</option><option value='B'>2</option><option value='C'>3</option><option value='D'>4</option><option value='E'>5</option></select><br>Your URL: http://<input type='text'name='df'><br>Border:<input type='text'name='ft'size='1'maxlength='1'><br><input type='submit'value='CREATE'></form>

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Created date: 28.08.2011
Thanks to: XtMania Indonesia