Skip to content
Permalink
main
Switch branches/tags

web-hack-mirror/mirror/2000/02/13/www.trak.co.il/form.htm

Go to file
 
 
Cannot retrieve contributors at this time
79 lines (75 sloc) 4.38 KB
Raw Blame
Open in GitHub Desktop
<html>
<head>
<title>New Page 1</title>
</head>
<body bgcolor="#000000" link="#00FFFF" vlink="#FF0000" alink="#00FFFF">
<div align="left">
<table border="0" width="400" cellspacing="0" cellpadding="0">
<tr>
<td width="100%" height="50" valign="bottom"><p align="center"><strong><u><font color="#00FF00">972-3-999-1111</font><font color="#00FF00" size="2"> : ñ÷ô êøã
øù÷ øåö<br>
</font></u></strong></td>
</tr>
<tr>
<td width="100%" valign="middle" height="50"><font color="#00FF00"><p align="center"></font><strong><font size="2" color="#00FFFF"><u><a href="mailto:trak@compunet.co.il">trak@compunet.co.il</a> :<a href="mailto:trak@compunet.co.il">éðåøè÷ìà øàåã êøã</a></u></font></strong></td>
</tr>
<tr>
<td width="100%" valign="bottom" height="50"><font color="#00FF00" size="2"><u><strong><p align="center">:ñôåè êøã</strong></u><br>
</font><font size="3" color="#00FF00">.åðúéà øù÷ úøéöéì äì÷ êøã êì
ïúåðå êìéáùá ãòåð äæ ñôåú</font><font color="#00FF00" size="2"><br>
</font></td>
</tr>
</table>
</div><div align="left">
<table border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="100%" align="center" valign="bottom" height="50"><form method="POST" action="_vti_bin/shtml.dll/form.htm" webbot-action="--WEBBOT-SELF--">
<!--webbot bot="SaveResults" S-Email-Format="TEXT/PRE" B-Email-Label-Fields="TRUE" S-Builtin-Fields S-Email-Address="trak@compunet.co.il" startspan --><input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><!--webbot bot="SaveResults" endspan i-checksum="43374" --><div align="center"><center><table border="0" cellpadding="0" width="502">
<tr>
<td width="1"><div align="left"><p><font color="#00FF00"><input type="text" name="home_address" size="11"></font></td>
<td width="253"><div align="left"><p><font color="#00FF00">:íéøåâî úáåúë</font></td>
<td width="58"></td>
<td width="1"><div align="left"><p><font color="#00FF00"><input type="text" name="full_name" size="11"></font></td>
<td width="398"><div align="left"><p><font color="#00FF00">:àìî íù</font></td>
</tr>
<tr>
<td width="1"><div align="left"><p><font color="#00FF00"><input type="text" name="home_phone" size="11"></font></td>
<td width="253"><div align="left"><p><font color="#00FF00">:úéáá 'ìè</font></td>
<td width="58"></td>
<td width="1"><div align="left"><p><font color="#00FF00"><input type="text" name="city" size="11"></font></td>
<td width="398"><div align="left"><p><font color="#00FF00">:ãå÷éîå øéò</font></td>
</tr>
<tr>
<td width="1"><div align="left"><p><font color="#00FF00"><input type="text" name="proffesion" size="11"></font></td>
<td width="253"><div align="left"><p><font color="#00FF00">:òåö÷î</font></td>
<td width="58"></td>
<td width="1"><div align="left"><p><font color="#00FF00"><input type="text" name="email" size="11"></font></td>
<td width="398"><div align="left"><p><font color="#00FF00">:éðåøè÷ìà øàåã</font></td>
</tr>
<tr>
<td width="1"><div align="left"><p><font color="#00FF00"><input type="text" name="work_phone" size="11"></font></td>
<td width="253"><div align="left"><p><font color="#00FF00">:äãåáòá 'ìè</font></td>
<td width="58"></td>
<td width="1"><div align="left"><p><font color="#00FF00"><input type="text" name="company" size="11"></font></td>
<td width="398"><div align="left"><p><font color="#00FF00">:äøáçä íù</font></td>
</tr>
<tr>
<td width="515" align="right" colspan="5" height="20"></td>
</tr>
<tr>
<td align="right" colspan="4" valign="middle" width="115"><font color="#00FF00"><div align="left"><p><textarea rows="4" name="comments" cols="44"></textarea></font></td>
<td width="398" align="left" valign="top"><font color="#00FF00"><div align="center"><center><p>:úåøòä</font></td>
</tr>
<tr align="center">
<td align="right" colspan="5" valign="middle" width="515" height="30"><div align="left"><p><br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input type="reset" value="C L E A R" name="B2">&nbsp;&nbsp; <input type="submit" value="S E N D" name="B1"></td>
</tr>
</table>
</center></div>
</form>
</td>
</tr>
</table>
</div>
</body>
</html>