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="17615">')
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 / Company')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="gastro" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('*Ulice a cislo / Street and nu')
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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 ('*PSC / ZIP Code')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="psc" VALUE="" SIZE="15">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('*Mesto / City')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="mesto" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('*Stat / Country')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="stat" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('*Pevna linka / Phone')
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')
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document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="email" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('*Funkce / Function')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="funkce" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('Titul / Degree')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="titul" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('*Jmeno / First name')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="jmeno" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('*Prijmeni / Surname')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="prijmeni" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('Poznamka / Comment')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="poznamka" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR><TD colspan=2 ALIGN=CENTER>')
document.write ('<INPUT TYPE=submit NAME="Odeslat" VALUE="Odeslat / Submit">')
document.write ('</TD></TR>')
document.write ('</TABLE>')
document.write ('</FORM>')
document.write (' ')