document.write ('<DIV ALIGN=CENTER>')
document.write ('<FORM METHOD="POST" ACTION="http://mailform.servery.cz/mf_send.php3" accept-charset="windows-1250">')
document.write ('<INPUT TYPE="hidden" NAME="mf_id" VALUE="15529">')
document.write ('<DIV ALIGN=CENTER>')
document.write ('<TABLE BORDER=0 BGCOLOR=white>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('Firma:')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="Firma" VALUE="" SIZE="60">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('IČO:')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="ICO" VALUE="" SIZE="15">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('DIČ:')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="DIC" VALUE="" SIZE="15">')
document.write ('</FONT></TD>')
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document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('Ulice:')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="Ulice" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('Město:')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="Mesto" VALUE="" SIZE="40">')
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document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('PSČ:')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="PSC" VALUE="" SIZE="10">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('Telefon:')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="Telefon" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('e-mail:')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="e-mail" VALUE="" SIZE="60">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('Výrobek:')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="Vyrobek" VALUE="" SIZE="60">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('Další údaje:')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="Udaje" VALUE="" SIZE="60">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR><TD colspan=2 ALIGN=LEFT>')
document.write ('<INPUT TYPE=submit NAME="odeslat" VALUE="Odeslat">')
document.write ('</TD></TR>')
document.write ('</TABLE>')
document.write ('</FORM>')
document.write (' ')