<FORM id="emf-form" name=calcform enctype="multipart/form-data" method="post" action="ordine_effettuato.html"> <TABLE cellSpacing=2 cellPadding=2 border=0> <tbody> <tr> <td><label>Nome: <input type="text"></label></td> <td><label> Cognome: <input type="text"></label></td> <td><label>Società: <input type="text"></label></td> </tr> <tr> <td><label>Via / P.zza: <input type="text"></label></td> <td><label> Città: <input type="text"></label></td> <td><label>Provicia / Stato: <input type="text"></label></td> </tr> <tr> <td><label>Telefono: <input type="text"></label></td> <td><label>Fax: <input type="text"></label></td> <td><label>Email: <input type="text"></label></td> </tr> </tbody> </table> <p align="center">
Mangimi Per Animali</p> <TABLE cellSpacing=2 cellPadding=2 border=0> <TBODY> <TR> <TD>Quantità <INPUT onchange=calculate() name=quantity1></TD> <TD>Prodotto <INPUT readonly="readonly" onchange=calculate() value=1.90 name=price1></TD> <TD>Prezzo <INPUT readonly="readonly" value=0.00 name=total1></TD></TR> <TR> <TD><INPUT onchange=calculate() name=quantity2></TD> <TD><INPUT onchange=calculate() name=price2></TD> <TD><INPUT value=0.00 name=total2></TD></TR> <TR> <TD><INPUT onchange=calculate() name=quantity3></TD> <TD><INPUT onchange=calculate() name=price3></TD> <TD><INPUT value=0.00 name=total3></TD></TR> <TR> <TD><INPUT onchange=calculate() name=quantity4></TD> <TD><INPUT onchange=calculate() name=price4></TD> <TD><INPUT value=0.00 name=total4></TD></TR> <TR> <TD><INPUT onchange=calculate() name=quantity5></TD> <TD><INPUT onchange=calculate() name=price5></TD> <TD><INPUT value=0.00 name=total5></TD></TR> <TR> <TD><INPUT onchange=calculate() name=quantity6></TD> <TD><INPUT onchange=calculate() name=price6></TD> <TD><INPUT value=0.00 name=total6></TD></TR> <TR> <TD><INPUT onchange=calculate() name=quantity7></TD> <TD><INPUT onchange=calculate() name=price7></TD> <TD><INPUT value=0.00 name=total7></TD></TR> <TR> <TD><INPUT onchange=calculate() name=quantity8></TD> <TD><INPUT onchange=calculate() name=price8></TD> <TD><INPUT value=0.00 name=total8></TD></TR> <TR> <TD><INPUT onchange=calculate() name=quantity9></TD> <TD><INPUT onchange=calculate() name=price9></TD> <TD><INPUT value=0.00 name=total9></TD></TR> <TR> <TD><INPUT onchange=calculate() name=quantity10></TD> <TD><INPUT onchange=calculate() name=price10></TD> <TD><INPUT value=0.00 name=total10></TD></TR> <TR> <TD></TD> <TD>Totale</TD> <TD><INPUT value=0.00 name=subtotal></TD></TR> <TR> <TD></TD> <TD>Iva 20%</TD> <TD><INPUT value=0.00 name=tax></TD></TR> <TR> <TD></TD> <TD>Totale</TD> <TD><INPUT value=0.00 name=total></TD></TR> </TBODY></TABLE> <font face="Verdana" size="2" color="#000000">
Data Di Consegna Dell'Ordine</font><span style="color:red;"> </span>
<select id="element_11_year-mm" name="element_11_day"><option value="1">1</option> <option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option> <option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option> <option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option> <option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option> <option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option> <option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option> <option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option> <option value="31">31</option></select> <select id="element_11_year-dd" name="element_11_month"><option value="1">1</option><option value="2">2</option> <option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option> <option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option> <option value="11">11</option><option value="12">12</option></select> <select id="element_11_year" name="element_11_year"> <option value="2010">2010</option><option value="2011">2011</option><option value="2012">2012</option> <option value="2013">2013</option><option value="2014">2014</option><option value="2015">2015</option> <option value="2016">2016</option><option value="2017">2017</option><option value="2018">2018</option> <option value="2019">2019</option><option value="2020">2020</option><option value="2021">2021</option> <option value="2022">2022</option><option value="2023">2023</option><option value="2024">2024</option> <option value="2025">2025</option><option value="2026">2026</option><option value="2027">2027</option> <option value="2028">2028</option><option value="2029">2029</option><option value="2030">2030</option> </select>
<INPUT onclick=calculate() type=button value="Calcola Il Totale">
<div style="padding-bottom:8px;color:#000000;">
<font face="Verdana"></font></div></td></tr><tr><td colspan="2"> <table cellpadding="5" cellspacing="0" bgcolor="#E4F8E4" width="50%"><tr bgcolor="#AAD6AA"><td colspan="2"> <font color="#FFFFFF" face="Verdana" size="2">
Image Verification</font></td></tr><tr> <td style="padding:2px; width:100px;">

</td> <td valign="top"><div><font color="#000000">Please enter the text from the image</font>:
<input type="text" id="captcha_code" name="captcha_code" maxlength="10" size="10" class="validate[required,funcCall[valid_captcha]]" />[
Refresh Image][
What's This?]</div> </td></tr></table></td></tr><tr><td colspan="2" align="left"><input name="element_counts" value="1" type="hidden" />