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="17732">')
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 ('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 ('*Redakce / Editor')
document.write ('</FONT></TD>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('')
document.write ('<INPUT TYPE=text NAME="Redakce" VALUE="" SIZE="40">')
document.write ('</FONT></TD>')
document.write ('</TR>')
document.write ('<TR>')
document.write ('<TD ALIGN="LEFT"><FONT COLOR=black>')
document.write ('Telefon / 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 ('*Ulice a cislo / Street and #')
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 ('*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 ('*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="10">')
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 ('*E-mail')
document.write ('</FONT></TD>')
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 ('Poznamka / Remark')
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><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 (' ')