<HTML>
<BODY>
 <form> 
<TABLE border="1">
 <TR>
  <TD>
   <TABLE border="2">
    <TR>
     <TD WIDTH="30%">
       Member Number:
     </TD>
         <TD WIDTH="70%">
      <INPUT NAME="EchoUser" TYPE="TEXT">
         </TD>
    </TR>
    <TR>
     <TD>
      PIN:
     </TD>
     <TD>
      <INPUT TYPE="password">
         </TD>
     <TD>
     </TD>
    </TR>
   </TABLE>
  </TD>
 </TR>
</TABLE>
</Form>
</BODY>
</HTML>