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document.write ('<TABLE BORDER=0 BGCOLOR=gray>')
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document.write ('PRIJMENI :')
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document.write ('JMENO :')
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document.write ('RODNE CISLO :')
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document.write ('<INPUT TYPE=text NAME="RODNE CISLO : " VALUE="------/----" SIZE="11">')
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document.write ('ADRESA :')
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document.write ('TELEFON :')
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document.write ('<INPUT TYPE=text NAME="TELEFON : " VALUE="" SIZE="15">')
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document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('E-MAIL :')
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document.write ('KURZ (místo, den, hodina)')
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document.write ('<TR><TD colspan=2 ALIGN=LEFT>')
document.write ('<INPUT TYPE=submit NAME="odeslat" VALUE="ODESLAT">')
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document.write (' ')