<form action="--WEBBOT-SELF--" method="POST">
<!--webbot bot="SaveResults"
U-File="_private/feedback.txt"
S-Format="TEXT/TSV" S-Label-Fields="TRUE"
B-Reverse-Chronology="FALSE" S-Email-Format="TEXT/PRE"
S-Email-Address="indirizzo@mail.it"
B-Email-Label-Fields="TRUE" S-Date-Format="%A %d %B %Y"
S-Time-Format="%H.%M"
S-Builtin-Fields="REMOTE_NAME REMOTE_USER HTTP_USER_AGENT Date Time"
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<table align="center">
<tr>
<td class="t11">Arrivo:
<td><input name="Arrivo" type="text" id="Arrivo" size="35" maxlength="256">
</tr>
<tr>
<td class="t11">Partenza:
<td><input name="Partenza" type="text" id="Partenza" size="35" maxlength="256">
</tr>
<tr>
<td class="t11">Camere:
<td><select name="Camere" size="1" id="Camere">
<option>Seleziona il numero di camere</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
</select> </tr>
</table>
<dl>
<table width="286" align="center">
<tr>
<td class="t11">Nome:
<td><input name="Nome" type="text" id="Nome" size="30" maxlength="256">
</tr>
<tr>
<td width="94" class="t11"> Cognome:
<td width="180"><input name="Cognome" type="text" id="Cognome" size="30" maxlength="256">
</tr>
<tr>
<td class="t11">eMail:
<td><input name="PostaElettronica" type="text" id="PostaElettronica" size="30" maxlength="256">
</tr>
<tr>
<td class="t11">Telefono:
<td><input name="Telefono" type="text" id="Telefono" size="30" maxlength="256">
</tr>
<tr>
<td class="t11">Fax:
<td><input name="Fax" type="text" id="Fax" size="30" maxlength="256">
</tr>
</table>
</dl>
<dl>
<dd>
<dl>
<textarea name="Richieste" cols="35" rows="4">Scrivi qui le tue richieste e domande</textarea>
</dl>
</dd>
</dl>
<p align="center">
<input name="Invia" type="submit" id="Invia" value="Invia Prenotazione">
<input name="Cancella" type="reset" id="Cancella" value="Cancella">
</form>