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<span style="font-size:12pt; color:#555;">Обратная связь</span><hr>

<script type="text/javascript">var sblmb1=0;function funTpaSt(){try {var tr=checksubmit();if(!tr){return false;}}catch(e){}if (sblmb1==1){return false;}sblmb1=1;new _uWnd('sendMFe1','Отправка сообщения',-350,-100,{autosize:0,modal:1,closeonesc:1,resize:0},{form:'mffTpaSt',type:'POST',url:'/mail/'});}</script><form method="post" name="mform" id="mffTpaSt" style="margin:0"  onsubmit="funTpaSt();return false;"><input type="hidden" name="jkd498" value="1"><input type="hidden" name="jkd428" value="1"><table border="0" width="100%" id="table1" cellspacing="1" cellpadding="2">
<tr><td width="35%">Имя отправителя <font color="red">*</font>:</td><td><input class="input11" type="text" name="f4" size="30" style="width:95%;" maxlength="70"></td></tr>
<tr><td>E-mail отправителя <font color="red">*</font>:</td><td><input class="input11" type="text" name="f1" size="30" style="width:95%;" maxlength="70"></td></tr>
<tr><td>Ваш сайт:</td><td><input class="input11" type="text" name="f5" size="30" style="width:95%;" maxlength="70"></td></tr>
<tr><td>Тема письма:</td><td><input class="input11" type="text" name="f2" size="30" style="width:95%;" maxlength="70"></td></tr>
<tr><td valign="top">Текст сообщения <font color="red">*</font>:</td><td><textarea class="input11" rows="7" name="f3" cols="30" style="width:95%;"></textarea></td></tr>

<tr><td>Оценка сайта:</td><td><select size="1" name="f6"><option>Отлично</option> <option>Хорошо</option> <option>Неплохо</option> <option>Плохо</option> <option>Ужасно</option></select></td></tr>
<tr><td>Код безопасности <font color="red">*</font>:</td><td><input class="input11" type="text" name="f7" size="4" maxlength="4" style="text-align:center;">$SECURITY_CODE$</td></tr>
<tr><td colspan="2" align="right"><hr><input type="submit" style="font-weight:bold" class="button" value="Отправить &raquo;"></td></tr>

</table><input type="hidden" name="id" value="1" /><input type="hidden" name="a" value="1" /><input type="hidden" name="o" value="1" /></form>
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