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13 lines (12 sloc) 297 Bytes
<html>
<head>
<title>Add Subscription</title>
</head>
<body>
<form method="POST">
Event: <input type="text" name="event" /><br />
Datapoint: <input type="text" name="datapoint" /><br />
<input type="submit" value="Add Subscription" />
</form>
</body>
</html>