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<font face="Verdana" size="2" color="#000000"><b style="font-size:20px;">Objednávka</b><br /><label style="font-size:15px;">Po dokončení a odeslání informací jděte na svůj email. Děkujeme.<br /></label><br /></font>
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</tr><tr valign="top" ><td id="td_element_label_0" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>Email</b></font>
<span style="color:red;"><small></small></span>
</td><td id="td_element_field_0" style=""><input id="element_0" name="element_0"
class="validate[optional,custom[email]]"
value="" size="30" type="text" /><div style="padding-bottom:8px;color:#000000;"><small><font face="Verdana"></font></small></div>
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</tr><tr valign="top" ><td id="td_element_label_1" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>Co chcete za službu ?</b></font>
<span style="color:red;"><small></small></span>
</td><td id="td_element_field_1" style=""><select id="element_1" name="element_1" class="validate[optional]"><option value="Facebook Timeline"selected="selected">Facebook Timeline</option><option value="Youtube kanál">Youtube kanál</option><option value="Skype Logo">Skype Logo</option><option value="Jiné...">Jiné...</option></select><div style="padding-bottom:8px;color:#000000;"><small><font face="Verdana"></font></small></div>
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</tr><tr valign="top" ><td id="td_element_label_2" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>Dodání služby :</b></font>
<span style="color:red;"><small></small></span>
</td><td id="td_element_field_2" style=""><select id="element_2" name="element_2" class="validate[optional]"><option value="2 dny + 29,-KČ">2 dny + 29,-KČ</option><option value="7 dní"selected="selected">7 dní</option><option value="14 dní">14 dní</option></select><div style="padding-bottom:8px;color:#000000;"><small><font face="Verdana"></font></small></div>
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</tr><tr valign="top" ><td id="td_element_label_3" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>Jak si obrázek představujete ?<br />
(Téma,vzhled)</b></font>
<span style="color:red;"><small></small></span>
</td><td id="td_element_field_3" style=""><textarea id="element_3" name="element_3" cols="45" rows="10"
class="validate[optional] "></textarea><div style="padding-bottom:8px;color:#000000;"><small><font face="Verdana"></font></small></div>
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<input name="element_counts" value="4" type="hidden" />
<input name="embed" value="forms" type="hidden" /><input value="Submit" type="submit" />
</td></tr></table></form><div style="margin-top:18px;text-align:center"><script type="text/javascript">generate_css_for_emf_ad();</script><div id='emf_advertisement'><font face="Verdana" size="2" color="#000000">Powered by</font><span style="position: relative; padding-left: 3px; bottom: -5px;"><img src="//assets.emailmeform.com/images/footer-logo.png" /></span><font face="Verdana" size="2" color="#000000">EMF </font><a style="text-decoration:none;" href="http://www.emailmeform.com/" target="_blank"><font face="Verdana" size="2" color="#000000">Contact Form</font></a></div><div><font face="Verdana" size="2" color="#000000"><a style="line-height:20px;font-size:70%;text-decoration:none;" href="http://www.emailmeform.com/report-abuse.html?http://www.emailmeform.com/builder/form/Q0et58S2D009V1rN" target="_blank">Report Abuse</a></font></div></div>
