<html>
<head>
<title>Form</title>
</head>
<body
style="color: rgb(0, 0, 0); background-color: rgb(192, 192, 192); width: 540px;"
alink="#000099" link="#000099" vlink="#990099">
<form method="post" action="email.php" name="Form">
<span style="font-family: Helvetica,Arial,sans-serif;">Modulo
di acquisto<br>
<br>
<small>Carica banner (dimensioni massime 120x90 pixel) <input
name="Carica banner" type="file"><br>
Link </small></span><small><span
style="font-family: Helvetica,Arial,sans-serif;"><input
maxlength="20" name="link" value="http://"></span></small><br>
<span style="font-family: Helvetica,Arial,sans-serif;"><small>Pagamento
<select name="Pagamento">
<option>paypal</option>
<option>accredito su postepay</option>
</select>
<br>
Periodo di pubblicazione
<select name="periodo">
<option>1 mese</option>
<option>2 mesi</option>
<option>3 mesi</option>
<option>4 mesi</option>
<option>5 mesi</option>
<option>6 mesi</option>
</select>
<br>
Tuo indirizzo e-mail <input name="Indirizzo email"><br>
<br>
<input name="Invia" value="Invia" type="submit"></small></span><small><span
style="font-family: Helvetica,Arial,sans-serif;"></span></small></form>
</body>
</html>