<FORM method="post" action="http://www.tecnoinformatica.com/cgi-bin/enviar.pl">
<input type="hidden" name="recipient" value="
[email protected]">
<input type="hidden" name="subject" value="Cibertienda - Orden de Compra">
<input type="hidden" name="redirect" value="http://tecnoinformaticagroup.com">
<input type="hidden" name="env_report" value="REMOTE_HOST,REMOTE_ADDR,HTTP_USER_AGENT">
<table cols="2" width="370" class="body">
<td width="130"></td>
<td width="270">
</td>
</tr>
<tr><td>Nombre</td><td><input type="text" name="nombre" size="34" /></td></tr>
<tr><td>Apellido</td><td><input type="text" name="apellido" size="34"/></td></tr>
<tr><td>Domicilio</td><td><input type="text" name="domicilio" size="34"/></td></tr>
<tr><td>Ciudad</td><td><input type="text" name="ciudad" size="34" /></td></tr>
<tr><td>Provincia</td><td><input type="text" name="provincia" size="34" /></td></tr>
<tr><td>Código Postal</td><td><input type="text" name="cp" size="34" /></td></tr>
<tr><td>País</td><td><input type="text" name="pais" size="34" /></td></tr>
<tr><td>E-mail</td><td><input type="text" name="email" size="34" /></td></tr>
<tr><td>Teléfono</td><td><input type="text" name="telefono" size="34" /></td></tr>
<tr><td>Fax</td><td><input type="text" name="fax" size="34" /></td></tr>
<SCRIPT language="JavaScript">
showItems();
</SCRIPT>
<tr>
<td>Total:</td>
<td>€
<SCRIPT language="JavaScript">Total()</SCRIPT>
</td>
</tr>
<tr></td>
<td><br/><br/></td>
<td></td>
<a href="index.html">
<input type="button" value="Enviar" onClick="return Enviar(this.form)"></a>
<input type="reset" value="Restablecer">