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Text File | 2007-10-18 | 1KB | 9 lines

<table border="0" width="100%" id="table1" cellspacing="1" cellpadding="2">
<tr><td width="35%">╚∞  ε≥∩≡αΓΦ≥σδ  <font color="red">*</font>:</td><td><input type="text" name="f4" size="30" style="width:95%;" maxlength="70"></td></tr>
<tr><td>E-mail ε≥∩≡αΓΦ≥σδ  <font color="red">*</font>:</td><td><input type="text" name="f1" size="30" style="width:95%;" maxlength="70"></td></tr>
<tr><td>└Σ≡σ± Γσß-±αΘ≥α:</td><td><input type="text" name="f5" size="30" style="width:95%;" maxlength="70"></td></tr>
<tr><td>╥σ∞α ∩Φ±ⁿ∞α:</td><td><input type="text" name="f2" size="30" style="width:95%;" maxlength="70"></td></tr>
<tr><td valign="top">╥σΩ±≥ ±εεß∙σφΦ  <font color="red">*</font>:</td><td><textarea rows="7" name="f3" cols="30" style="width:95%;"></textarea></td></tr>
<tr><td>╬÷σφΩα ±αΘ≥α:</td><td><select size="1" name="f6"><option>╬≥δΦ≈φε</option><option>╒ε≡ε°ε</option><option>═ε≡∞αδⁿφε</option><option>╧δε⌡ε</option><option>╙µα±φε</option></select></td></tr>
<tr><td colspan="2" align="center"><br /><input type="submit" value="½ ╬≥∩≡αΓΦ≥ⁿ ±εεß∙σφΦσ ╗"></td></tr>
</table>