<html>
<head>
</head>
<body>
<form name="frm">
Valore Link:
<input type="radio" name="valore_link" value="0.003">0.003$
<input type="radio" name="valore_link" value="0.005">0.005$
<input type="radio" name="valore_link" value="0.007">0.007$
<input type="radio" name="valore_link" value="0.01">0.01$
Numero di Clicks:
<input type="text" name="qtot">
Prezzo Temporaneo:
<input type="text" name="prezzo_temp" readonly="readonly" >
Tipo di Visita:
<input type="radio" name="tipo_visita" value="1">visite 24h
<input type="radio" name="tipo_visita" value="2">Visite Uniche
Opzioni:
<input type="checkbox" name="rosso" value="1">Testo Rosso
<input type="checkbox" name="grassetto" value="1">Testo In Grassetto
<input type="checkbox" name="uppercase" value="1">Testo Uppercase
TOTALE:
<input type="text" name="prezzo_tot" readonly="readonly">
</form>
</body>
</html>