ACC SHELL

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<div align="center"> 
  <b><font face="Arial" style="font-size: 9pt">KONTAKTNÍ FORMULÁŘ</font></b></div>

<form method="POST" action="mail.php">
  <font face="Arial"><span style="font-size: 9pt">
  </span></font>
  <div align="center">
  <table border="0" id="table1" cellspacing="0" cellpadding="2">
    <tr> 
      <td class="TextForm" align="right" valign="top">
		<b><font face="Arial" style="font-size: 9pt" color="#000000">Typ zboží a 
		popis objedn</font></b><font color="#000000" face="Arial" style="font-size: 9pt"><b>ávky:</b><br>
		&nbsp;</font></td>
      <td><span style="font-size: 9pt"><font face="Arial" color="#D2D2D2"> 
        <textarea cols="33" rows="6" name="objednavka" wrap></textarea></font><font face="Arial">
		</font></span></td>
    </tr>
    <tr> 
      <td class="TextForm" align="right">
		<font color="#000000" face="Arial" style="font-size: 9pt">Termín dodání:</font></td>
      <td><span style="font-size: 9pt"><font face="Arial" color="#D2D2D2"> 
        <input type="Text" name="den" size="2" maxlength="2" value="01"></font><font face="Arial">
        &nbsp; 
        </font><font face="Arial" color="#D2D2D2"> 
        <select name="mesic">
          <option value="01">leden 
          <option value="02">únor 
          <option value="03">březen 
          <option value="04">duben 
          <option value="05">květen 
          <option value="06">červen 
          <option value="07">červenec 
          <option value="08">srpen 
          <option value="09">září 
          <option value="10">říjen 
          <option value="11">listopad 
          <option value="12">prosinec 
        </select><font face="Arial">
        &nbsp; 
        </font> 
        <select name="rok" size="1">
          <option>2006 
          <option>2007
          <option>2008	  
        </select><font face="Arial">
        &nbsp; </font></font></span></td>
    </tr>
    <tr> 
      <td class="TextForm" align="right">
		<font color="#000000" face="Arial" style="font-size: 9pt">Firma:</font></td>
      <td> <span style="font-size: 9pt"><font face="Arial" color="#D2D2D2"> 
        <input type="Text" name="firma1" size="20" maxlength="50"></font><font face="Arial">
		</font></span></td>
    </tr>
    <td class="TextForm" align="right">
	<font color="#000000" face="Arial" style="font-size: 9pt">Jméno a příjmení:</font></td>
    <td> <span style="font-size: 9pt"><font face="Arial" color="#D2D2D2"> 
      <input type="Text" name="jmeno" size="20" maxlength="50"></font><font face="Arial">
	</font></span></td>
    </tr>
    <td class="TextForm" align="right">
	<font color="#000000" face="Arial" style="font-size: 9pt">E-mail</font></td>
    <td> <span style="font-size: 9pt"><font face="Arial" color="#D2D2D2"> 
      <input type="Text" name="email" size="20" maxlength="50"></font><font face="Arial">
	</font></span></td>
    </tr>
    <td class="TextForm" align="right">
	<font color="#000000" face="Arial" style="font-size: 9pt">Telefon:</font></td>
    <td> <span style="font-size: 9pt"><font face="Arial" color="#D2D2D2"> 
      <input type="Text" name="telefon" size="20" maxlength="50"></font><font face="Arial">
	</font></span></td>
    </tr>
    <td class="TextForm" align="right">
	<font color="#000000" face="Arial" style="font-size: 9pt">Fax:</font></td>
    <td> <span style="font-size: 9pt"><font face="Arial" color="#D2D2D2"> 
      <input type="Text" name="fax" size="20" maxlength="50"></font><font face="Arial">
	</font></span></td>
    </tr>
    <tr> 
      <td align="right">&nbsp;</td>
      <td align="right"><font face="Arial" color="#D2D2D2"> 
        <input style="font-size: 12px" type="Submit" name="btn" value="Odeslat"></font><font face="Arial"><span style="font-size: 9pt">
		</span></font></td>
    </tr>
  </table>

	</div>

</form>

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