<form method="get" action="https://cscie12.dce.harvard.edu/echo">
Email Address:
<input type="text" name="email" size="50"/><br/>Year of Birth:
<input type="text" name="year_of_birth" size="50" maxlength="4"/><br/>Year of Birth:
<input type="text" name="year_of_birth_2" size="5" maxlength="4"/><br/>
<input type="submit" name="action" value="Proceed"/>
</form>