<form method="post">
<table cellpadding="2">
<tr><th>&nbsp;</th><td align="right"><input name="emp_cancel_b" size="40" type="checkbox" /></td></tr>
<tr><th>Emp ID</th><td>123<input name="emp_id" type="hidden" value="123" /></td></tr>
<tr><th>Emp Name</th><td><input maxlength="255" name="emp_name" size="40" type="text" value="Fred Flintstone" /></td></tr>
<tr><th>Emp Title</th><td><input maxlength="255" name="emp_title" size="40" type="text" value="CEO" /></td></tr>
<tr><td align="center" colspan="2">
<input id="submit" name="submit" type="submit" value="Submit" />
</td></tr>
</table>
</form>