document.write('<FORM name="frm" method="post" action="http://www7.dr.myx.net/forms_data.html" > <input type="hidden"');
document.write('name="domain" value="afaceri-online">  <input type="hidden" name="formular" value="formular-comanda">  <input type="hidden" ');
document.write('name="trimite_pe_mail" value="comanda@afaceri-online.net">	  <input type="hidden" name="redirect_catre" value="http://www.af');
document.write('aceri-online.net/confirmare-comanda-carti.htm">      <TABLE cellSpacing="0" cellPadding="1" style="BORDER-RIGHT: #0000');
document.write('00 1px solid; BORDER-TOP: #000000 1px solid; FONT-SIZE: 10px; BORDER-LEFT: #000000 1px solid; COLOR: #000000; BORDER-BOT');
document.write('TOM: #000000 1px solid; BACKGROUND-COLOR: #cccccc">      <TR>         <TD> 		<TABLE cellSpacing="0" cellPadding="1');
document.write('2" border="0" width="537">            <TR>               <TD align="justify" width="513"> 				<TABLE cellSpacing="');
document.write('0" cellPadding="0" width="509" border="0">                  <TR>                     <TD align="justify" colSpan="2"');
document.write(' width="509"> 					<TABLE cellSpacing="0" cellPadding="0" border="0" width="100%">                        <TR>    ');
document.write('                       <TD width="100%"> <P align="center"> <B> <FONT face="verdana,helvetica, arial"  color="#F26522"> ');
document.write('                                <br>							</FONT><FONT face="verdana,helvetica, arial" > 							Completeaza si tr');
document.write('imite<br>formularul de comanda de mai jos</FONT>							<FONT face="verdana,helvetica, arial"  color="#F26522"><br>&nbs');
document.write('p;</FONT></B></TD>                        </TR>                      </TABLE></TD>                  </TR>       ');
document.write('           <TR>                     <TD width="242"> <FONT color="#ffffff"> <BR>                      </FONT> <FONT ');
document.write('face="Verdana,Arial,Helvetica" > 					<B>Numele si Prenumele</B></FONT><FONT color="#ffffff"><BR>                   ');
document.write('   <INPUT size="41" name="nume" style="BORDER-RIGHT: #000000 1px solid; BORDER-TOP: #000000 1px solid; FONT-SIZE: 12px; ');
document.write('BORDER-LEFT: #000000 1px solid; COLOR: #000000; BORDER-BOTTOM: #000000 1px solid; BACKGROUND-COLOR: #ffffff">         ');
document.write('             <BR><BR>                      </FONT> <B> <FONT face="Verdana,Arial,Helvetica" >                       ');
document.write('E-mail </FONT> 					<FONT face="Verdana,Arial,Helvetica" style="font-size: 7pt">                       (daca ai, pt.');
document.write(' contacte ulterioare)</FONT></B><FONT color="#ffffff"><BR>                      <INPUT size="41" name="email" style="B');
document.write('ORDER-RIGHT: #000000 1px solid; BORDER-TOP: #000000 1px solid; FONT-SIZE: 12px; BORDER-LEFT: #000000 1px solid; COLOR: #');
document.write('000000; BORDER-BOTTOM: #000000 1px solid; BACKGROUND-COLOR: #ffffff">                      <br><BR>                 ');
document.write('     </FONT> <B> <FONT face="Verdana,Arial,Helvetica" >                       Mentiuni suplimentare </FONT> 					<FO');
document.write('NT face="Verdana,Arial,Helvetica" style="font-size: 7pt">(eventual)                      </FONT><FONT color="#999999" ');
document.write('face="Verdana,Arial,Helvetica" style="font-size: 7pt">                       </FONT> </B> <FONT color="#999999" face="');
document.write('Verdana,Arial,Helvetica" >&nbsp;                       </FONT> <FONT color="#ffffff"> <BR>                      <INP');
document.write('UT size="41" name="mentiune" style="BORDER-RIGHT: #000000 1px solid; BORDER-TOP: #000000 1px solid; FONT-SIZE: 12px; BOR');
document.write('DER-LEFT: #000000 1px solid; COLOR: #000000; BORDER-BOTTOM: #000000 1px solid; BACKGROUND-COLOR: #ffffff">            ');
document.write('          <BR>                      </FONT></TD>                    <TD width="267"> 					<FONT face="Verdana,Aria');
document.write('l,Helvetica" >                       <B>Lucrarea aleasa:</B></FONT><FONT color="#808080" face="Verdana,Arial,Helvetica');
document.write('" >&nbsp;                       </FONT> <BR> &nbsp; <TABLE border="0" cellpadding="0" cellspacing="0" style="border-co');
document.write('llapse: collapse" width="100%" id="AutoNumber2">                        <TR>                           <TD width="10');
document.write('0%"> <FONT color="#808080" face="Verdana,Arial,Helvetica" >                             <INPUT type=checkbox name=Prom');
document.write('ovarea value="DA">                            </FONT><FONT face="Verdana,Arial,Helvetica" >                         ');
document.write('    Promovarea Online a Site-urilor Web</FONT><FONT color="#808080" face="Verdana,Arial,Helvetica" >&nbsp;            ');
document.write('                 </FONT> </TD>                        </TR>                        <TR>                           ');
document.write('<TD width="100%"> <FONT color="#808080" face="Verdana,Arial,Helvetica" >                             <INPUT type=check');
document.write('box name=Html_Css_Xml value="DA">                            </FONT><FONT face="Verdana,Arial,Helvetica" >          ');
document.write('                   HTML, CSS, XML - profesional </FONT> </TD>                        </TR>                          ');
document.write('                      <TR>                           <TD width="100%"> <FONT color="#808080" face="Verdana,Arial,Helve');
document.write('tica" >                             <INPUT type=checkbox name=Java_JavaScript value="DA"> 							</FONT><FONT face="');
document.write('Verdana,Arial,Helvetica"> 							Java, JavaScript - profesional </FONT> </TD>                        </TR>        ');
document.write('              </TABLE>&nbsp; </TD>                  </TR>                  <TR>   ');
document.write('                  <TD width="242"> 	<BR><BR>			<FONT face="Verdana,Arial,Helvetica" >                       <B>Adresa posta');
document.write('la de livrare</B></FONT>                       <script type="text/javascript" src="images/clean.js"></script>       ');
document.write('                <textarea name="adresa" rows="6" wrap="VIRTUAL" cols="29" onFocus="clearText(this)" style="BORDER-RIGHT:');
document.write(' #000000 1px solid; BORDER-TOP: #000000 1px solid; FONT-SIZE: 12px; BORDER-LEFT: #000000 1px solid; COLOR: #000000; BORD');
document.write('ER-BOTTOM: #000000 1px solid; BACKGROUND-COLOR: #ffffff">Tasteaza aici adresa fizica la care vom livra pachetul.</textar');
document.write('ea><br>&nbsp;</TD>                    <TD vAlign="bottom" align="justify" width="267"> <P align="center">           ');
document.write('              <INPUT type="submit" value="Trimite " name="submit" >                        <BR>                      ');
document.write('  <BR>                        <INPUT type="reset" value="Reseteaza" name="reset"> <br>						<br>&nbsp;</TD>       ');
document.write('           </TR>                </TABLE></TD>            </TR>          </TABLE></TD>      </TR>    </TABLE>');
document.write('  </FORM>');