<html>
<head>
<title>gennygold18</title>
<meta name="Robots" content="index,follow">
<meta name="revisit-after" content="20 days">
<link rel="stylesheet" href="./TESTO.css" type="text/css">
<STYLE>
A:link {
FONT-SIZE: 8pt; COLOR: #999999; FONT-FAMILY: Verdana; TEXT-DECORATION: none
}
A:visited {
FONT-SIZE: 8pt; COLOR: #999999; FONT-FAMILY: Verdana; TEXT-DECORATION: none
}
A:hover {
FONT-SIZE: 8pt; COLOR: #C8C8C8; FONT-FAMILY: Verdana; TEXT-DECORATION: underline
}
.Stile1 {
color: #FFCC00;
font-size: 16px;
}
.Stile3 {color: #FFCC00; font-size: 16px; font-weight: bold; }
.Stile4 {font-size: 16px}
</STYLE>
</head>
<body bgcolor="#000000" text="#000000" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0">
<table width="64%" border="0" align="center" cellpadding="0" cellspacing="0">
<tr>
<td valign="top">
<div align="center">
<FORM name=modulo action=mailto:matrix1976fm@libero.it
method=post encType=text/plain on-line>
<input type="hidden" name="invia_Dati">
<input type="hidden" name="redirect" value="./grazie.html">
<table width="482" border="0" align="center" cellpadding="0" cellspacing="0">
<tr>
<td height="25" colspan="2" class="Stile1">CONTACT PLEASE: </td>
<td width="29" height="253" rowspan="13" class="normal">
<div align="center"> </div>
</td>
</tr>
<tr>
<td width="112" height="6"> <font size="1" face="Verdana, Arial, Helvetica, sans-serif">
</font></td>
<td width="341"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
</font></td>
</tr>
<tr>
<td height="6"><div align="right" class="Stile1">NAME:</div></td>
<td width="341"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<input name=NAME id="NAME2" size=50>
</font></td>
</tr>
<tr>
<td height="13" class="Stile3"><div align="right">SURNAME:</div></td>
<td width="341"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<input name=SURNAME id="SURNAME3" size=50>
</font></td>
</tr>
<tr>
<td height="12"><div align="right" class="Stile1">CITY:</div></td>
<td height="12"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<input name=CITY id="CITY3" size=50>
</font></td>
</tr>
<tr>
<td height="13"><div align="right" class="Stile3"><font face="Verdana, Arial, Helvetica, sans-serif">ADDRESS:</font></div></td>
<td height="13"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<input name=ADDRESS id="ADDRESS3" size=50>
</font></td>
</tr>
<tr>
<td height="25"><div align="right"><font face="Verdana, Arial, Helvetica, sans-serif" class="Stile3">COUNTRY: </font> </div></td>
<td height="25"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<input name=COUNTRY id="COUNTRY2" size=37>
</font></td>
</tr>
<tr>
<td height="25"><div align="right"><font face="Verdana, Arial, Helvetica, sans-serif" class="Stile3 Stile4">ZIP CODE: </font> </div></td>
<td height="25"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<input name=ZIP CODE id="ZIP CODE" size=11>
</font></td>
</tr>
<tr>
<td height="25"><div align="right" class="Stile3"><font face="Verdana, Arial, Helvetica, sans-serif"> TELEFON: </font></div></td>
<td height="25"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<input name=TELEFON id="TELEFON3" size=50>
</font></td>
</tr>
<tr>
<td height="25"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
</font></td>
<td height="25"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<input name=E-MAIL id="E-MAIL2" size=50>
</font></td>
</tr>
<tr>
<td height="25"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
</font></td>
<td height="25"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<textarea name="NOTE" cols="50" rows="5" id="textarea"></textarea>
</font></td>
</tr>
<tr>
<td height="25" colspan="2"><div align="right"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<input type="submit" name="Submit" value="SEND">
<input type="reset" name="Reset" value="CANCEL">
</font></div></td>
</tr>
<tr valign="bottom">
<td height="28" colspan="2"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
</font></td>
</tr>
</table>
<p class="Stile1"> </p>
</FORM>
</div>
</td>
</tr>
</table>
<div align="center"></div>
</body>
</html>
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