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<DIV><FONT face=Arial size=2></FONT> </DIV>
<DIV align=center><FONT face=Arial size=2><IMG alt="" hspace=0
src="http://www.server75.com.br/figuras/planounico.jpg" align=baseline
border=0></A></FONT></DIV>
<p>Sistema valido para o Estado de Sao Paulo.
<p>Contatos: Caso voce use "webmail" utilize formulario no site:<a
href=http://www.server75.com.br/form_unico.htm>Formulario</a>
<p>Caso seja via Outlook e outros, utilize o formulario abaixo:
<script src="http://www.linkws.com/js/s_validate.js" type='text/javascript'
charset="iso-8859-1"></script>
<script>
function validateForm_92084(form) {
var validator = new Validator();
validator.validateSimpleTextField(form.assunto,"Erro no campo: Assunto do
contato");validator.validateSimpleTextField(form.nome,"Erro no campo:
Nome");validator.validateEmailField(form.email,"Erro no campo:
E-mail");validator.validateSimpleTextField(form.email,"Erro no campo:
E-mail");validator.validateSimpleTextField(form.tel,"Erro no campo: Telefone
com DDD");validator.validateSimpleTextField(form.valor,"Erro no campo: Valor
pretendido");validator.validateSimpleTextField(form.cidade,"Erro no campo:
Cidade");validator.validateComboField(form.uf,"Erro no campo: Estado");
if (validator.processLog()) {
if (form.sendBtn) {
form.sendBtn.disabled = true;
}
return true;
} else {
return false;
}
}
</script>
<form method="post" action="http://www.linkws.com/proc/superProc.jsp"
accept-charset="iso-8859-1" onSubmit="return validateForm_92084(this);" >
<input type="hidden" name="actionID" value="18">
<input type="hidden" name="_charset_" value="">
<input type="hidden" name="userProductID" value="92084">
<script>document.write("<input type='hidden' name='__referer_1'
value='"+document.referrer+"'>");</script>
<table width="100%" border="0" cellspacing="2" cellpadding="0">
<tr>
<td width="150" valign="top" bgcolor="#F5F5F5"> <font size="1"
face="Verdana, Arial, Helvetica, sans-serif"><strong>Assunto do
contato</strong></font> </td>
<td> </td>
<td valign="top"> <font size="2" face="Verdana, Arial, Helvetica,
sans-serif"><input name="assunto" value="Plano Unico" size="50"
maxlength="128" class="fieldStyle"></font></td>
</tr>
<tr>
<td width="150" valign="top" bgcolor="#F5F5F5"> <font size="1"
face="Verdana, Arial, Helvetica, sans-serif"><strong>Nome</strong></font>
</td>
<td> </td>
<td valign="top"> <font size="2" face="Verdana, Arial, Helvetica,
sans-serif"><input name="nome" value="" size="50" maxlength="128"
class="fieldStyle"></font></td>
</tr>
<tr>
<td width="150" valign="top" bgcolor="#F5F5F5"> <font size="1"
face="Verdana, Arial, Helvetica, sans-serif"><strong>E-mail</strong></font>
</td>
<td> </td>
<td valign="top"> <font size="2" face="Verdana, Arial, Helvetica,
sans-serif"><input name="email" value="" size="50" maxlength="255"
class="fieldStyle"></font></td>
</tr>
<tr>
<td width="150" valign="top" bgcolor="#F5F5F5"> <font size="1"
face="Verdana, Arial, Helvetica, sans-serif"><strong>Telefone com
DDD</strong></font> </td>
<td> </td>
<td valign="top"> <font size="2" face="Verdana, Arial, Helvetica,
sans-serif"><input name="tel" value="" size="25" maxlength="20"
class="fieldStyle"></font></td>
</tr>
<tr>
<td width="150" valign="top" bgcolor="#F5F5F5"> <font size="1"
face="Verdana, Arial, Helvetica, sans-serif"><strong>Celular do
DDD</strong></font> </td>
<td> </td>
<td valign="top"> <font size="2" face="Verdana, Arial, Helvetica,
sans-serif"><input name="celular" value="" size="30" maxlength="255"
class="fieldStyle"></font></td>
</tr>
<tr>
<td width="150" valign="top" bgcolor="#F5F5F5"> <font size="1"
face="Verdana, Arial, Helvetica, sans-serif"><strong>Empresa</strong></font>
</td>
<td> </td>
<td valign="top"> <font size="2" face="Verdana, Arial, Helvetica,
sans-serif"><input name="empresa" value="" size="50" maxlength="128"
class="fieldStyle"></font></td>
</tr>
<tr>
<td width="150" valign="top" bgcolor="#F5F5F5"> <font size="1"
face="Verdana, Arial, Helvetica, sans-serif"><strong>Valor
pretendido</strong></font> </td>
<td> </td>
<td valign="top"> <font size="2" face="Verdana, Arial, Helvetica,
sans-serif"><input name="valor" value="" size="30" maxlength="255"
class="fieldStyle"></font></td>
</tr>
<tr>
<td width="150" valign="top" bgcolor="#F5F5F5"> <font size="1"
face="Verdana, Arial, Helvetica,
sans-serif"><strong>Mensagem</strong></font> </td>
<td> </td>
<td valign="top"> <font size="2" face="Verdana, Arial, Helvetica,
sans-serif"><textarea name="mensagem" cols="40" rows="5" class="fieldStyle"
onKeyDown="limitTextArea(this, this.form._COUNTER_FIELD_mensagem, 255);"
onKeyUp="limitTextArea(this, this.form._COUNTER_FIELD_mensagem,
255);"></textarea><input class="fieldStyle" disabled
name="_COUNTER_FIELD_mensagem" size="3" value="255"></font></td>
</tr>
<tr>
<td width="150" valign="top" bgcolor="#F5F5F5"> <font size="1"
face="Verdana, Arial, Helvetica, sans-serif"><strong>Cidade</strong></font>
</td>
<td> </td>
<td valign="top"> <font size="2" face="Verdana, Arial, Helvetica,
sans-serif"><input name="cidade" value="" size="40" maxlength="60"
class="fieldStyle"></font></td>
</tr>
<tr>
<td width="150" valign="top" bgcolor="#F5F5F5"> <font size="1"
face="Verdana, Arial, Helvetica, sans-serif"><strong>Estado</strong></font>
</td>
<td> </td>
<td valign="top"> <font size="2" face="Verdana, Arial, Helvetica,
sans-serif"><select name="uf" class="fieldStyle"><option
value="Nenhum">Nenhum</option><option value="Acre">Acre</option><option
value="Alagoas">Alagoas</option><option value="Amapá">Amapá</option><option
value="Amazonas">Amazonas</option><option
value="Bahia">Bahia</option><option value="Ceará">Ceará</option><option
value="Distrito Federal">Distrito Federal</option><option value="Espírito
Santo">Espírito Santo</option><option value="Góias">Góias</option><option
value="Maranhão">Maranhão</option><option value="Mato Grosso">Mato
Grosso</option><option value="Mato Grosso do Sul">Mato Grosso do
Sul</option><option value="Minas Gerais">Minas Gerais</option><option
value="Pará">Pará</option><option value="Paraíba">Paraíba</option><option
value="Paraná">Paraná</option><option
value="Pernambuco">Pernambuco</option><option
value="Piauí">Piauí</option><option value="Rio de Janeiro">Rio de
Janeiro</option><option value="Rio Grande do Norte">Rio Grande d
o Norte</option><option value="Rio Grande do Sul">Rio Grande do
Sul</option><option value="Rondônia">Rondônia</option><option
value="Roraima">Roraima</option><option
value="Tocantins">Tocantins</option><option value="Santa Catarina">Santa
Catarina</option><option value="São Paulo">São Paulo</option><option
value="Sergipe">Sergipe</option></select></font></td>
</tr>
</table>
<p>
<input name="sendBtn" type="submit" value="Enviar">
<input type="reset" value="Limpar">
<br>
<br>
</p>
</form>
<IMG alt="" hspace=0
src="http://www.server75.com.br/figuras/rodape01.jpg" align=baseline
border=0></A></FONT></DIV>
Caso nao queira mais receber: <a
href="mailto:free@eletromarketing.com.br?subject=sair_plano_unico">Out</a>
<img src="http://www.server75.com.br/asp/confirmacao.asp?email=debian-med-p
ackaging@lists.alioth.debian.org" width="10" height="10">
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