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Formularz kontaktowy - Capital Sp. z o.o. <div style="position: static; z-index:15;"> <div class="yui-u" id="boxcenter" style="width:660px"> <br /> <img src="/images_user/header_dot.gif" class="dot-title" alt="dot"><h1>Formularz kontaktowy</h1> <tr> <td> <div class="yui-u" id="boxcenter"> <form action="?a=wyslane" method="post"> <table class="formularz" border="0" cellpadding="0" cellspacing="0" width="100%" bgcolor="#e0e0e0"> <tbody><tr> <td>     </td> <td class="formularz" align="right" height="60"> <label>Treść:<font color=red><b>*</b></font></label><label>      <textarea name="tresc" class="inp-txt" cols="15" rows="10" align="right"> </textarea> </label></td> <td class="formularz" valign="top"> <br> <table width="347"> <tbody><tr> <td class="formularz" nowrap="nowrap" align="right"> <label>Nazwa firmy<font color=red><b>*</b></font>  </label> </td> <td class="formularz"><input name="firma" value="" class="inp" type="text"> </td> </tr> <tr> <td class="formularz" nowrap="nowrap" align="right"><label>Nazwisko<font color=red><b>*</b></font>  </label> </td> <td class="formularz"><input name="nazwisko" value="" class="inp" type="text"> </td> </tr> <tr> <td class="formularz" nowrap="nowrap" align="right"><label>Imię  </label><label> </label></td> <td class="formularz"><input name="imie" value="" class="inp" type="text"> </td> </tr> <tr> <td class="formularz" nowrap="nowrap" align="right"><label>Ulica  </label> </td> <td class="formularz"><input name="ulica" value="" class="inp" type="text"> </td> </tr> <tr> <td class="formularz" nowrap="nowrap" align="right"><label>Kod pocztowy  </label> </td> <td class="formularz"><input name="kod1" class="inpkod1" size="2" value="" type="text">- <input name="kod2" size="5" class="inpkod2" value="" type="text"> </td> </tr> <tr> <td class="formularz" nowrap="nowrap" align="right"><label>Miasto  </label> </td> <td class="formularz"><input name="miasto" value="" class="inp" type="text"> </td> </tr> <tr> <td class="formularz" nowrap="nowrap" align="right"><label>Kraj  </label> </td> <td class="formularz"><input name="kraj" value="" class="inp" type="text"> </td> </tr> <tr> <td class="formularz" nowrap="nowrap" align="right"><label>Telefon  </label> </td> <td class="formularz"><input name="telefon" value="" class="inp" type="text"> </td> </tr> <tr> <td class="formularz" nowrap="nowrap" align="right"><label>Fax  </label> </td> <td class="formularz"><input name="fax" value="" class="inp" type="text"> </td> </tr> <tr> <td class="formularz" nowrap="nowrap" align="right"><label>E-mail<font color=red><b>*</b></font>  </label> </td> <td class="formularz"><input name="email" value="" class="inp" type="text"> </td> </tr> </tbody></table> </td> </tr> <tr height="30"> </td> </tr> </tbody></table> <strong><strong> </strong></strong>                                                                                               <td colspan="2" align="right"><input name="send" src="/images/wyslij.png" type="image"></form> <font color=red><b>*</b></font> Należy wypełnić obowiązkowo </div> <div class="yui-u" id="boxright"></div> </div></div> </div> </div> </div></div></div></div> <div id="ft"> <div class="yui-g"> </div> <br /> <p>Copyright by Capital 2010 - Rusztowania i szalunki</p> <br> </div> </body> </html>