Código HTML:
<table width="632" border="0" cellpadding="0" cellspacing="0"> <tr> <td width="50"> </td> <td width="49" valign="top"></td> <td width="533" valign="top"><form action="" method="post" name="form" id="form" onsubmit="return validar(form)"> <table border="0" cellpadding="1" cellspacing="1"> <tr> <td>Type:</td> <td bgcolor="#590000">Reservation <input name="Tipo" type="radio" value="Reserva" checked="checked" /> Consult <input name="Tipo" type="radio" value="Consulta" /></td> </tr> <tr> <td>Full name: </td> <td bgcolor="#590000"><input name="Nombres" type="text" class="form01" id="Nombres" size="40" /> *</td> </tr> <tr> <td>Address:</td> <td bgcolor="#590000"><input name="Direccion" type="text" class="form01" id="Direccion" size="40" /> *</td> </tr> <tr> <td>City:</td> <td bgcolor="#590000"><input name="Ciudad" type="text" class="form01" id="Ciudad" size="40" /> *</td> </tr> <tr> <td>Country:</td> <td bgcolor="#590000"><select name="Pais" class="form01" id="Pais" > <option value="0">Select your country</option> <option value="US">United States </option> <option value="AF">Afghanistan </option> <option value="AL">Albania </option> <option value="DZ">Algeria </option> <option value="AS">American Samoa </option> </select> *</td> </tr> <tr> <td> passport number:</td> <td bgcolor="#590000"><input name="Pasaporte" type="text" class="form01" id="Pasaporte" size="40" /> *</td> </tr> <tr> <td>e-mail:</td> <td bgcolor="#590000"><input name="email" type="text" class="form01" id="email" size="40" /> *</td> </tr> <tr> <td>Nº Persons:</td> <td bgcolor="#590000"><input name="Npersonas" type="text" class="form01" id="Npersonas" size="10" /></td> </tr> <tr> <td>Programs:</td> <td bgcolor="#590000"><select name="Programas" class="form01" id="Programas"> <option value="0">Select a program</option> <option value="Ausangate Expedition">Ausangate Expedition</option> <option value="Choquequirao Trek 5 Days & 4 Nights">Choquequirao Trek 5 Days & 4 Nights</option> <option value="Choquequirao Trek 4 Days & 3 Nights">Choquequirao Trek 4 Days & 3 Nights</option> <option value="Espiritu Pampa Expedition">Espiritu Pampa Expedition</option> <option value="Inka Trail 4 Days & 3 Nights">Inka Trail 4 Days & 3 Nights</option> <option value="Salkantay - Machu Picchu Expedition">Salkantay - Machu Picchu Expedition</option> <option value="Short Program to Machu Picchu">Inka Trail 2 Days & 1 Night</option> <option value="The Combo Expedition: Choquequirao & Machu Picchu">The Combo Expedition: Choquequirao & Machu Picchu</option> <option value="The Deep Peru Expedition: Salkantay to Machu Picchu">The Deep Peru Expedition: Salkantay to Machu Picchu</option> <option value="Trip Cusco - Puno by Bus">Trip Cusco - Puno by Bus</option> <option value="Mountain Biking">Mountain Biking</option> <option value="Rafting Tours">Rafting Tours</option> </select></td> </tr> <tr> <td>Planned arrival:</td> <td bgcolor="#590000"><table border="0" cellpadding="2"> <tr class="form02"> <td> Day :</td> <td><select name="Dia" size="1" class="form01" id="Dia"> <option value="0">--</option> <option value="01">01</option> <option value="02">02</option> <option value="03">03</option> <option value="04">04</option> <option value="05">05</option> <option value="06">06</option> <option value="07">07</option> <option value="08">08</option> <option value="09">09</option> <option value="10">10</option> <option value="11">11</option> <option value="12">12</option> <option value="13">13</option> <option value="14">14</option> <option value="15">15</option> <option value="16">16</option> <option value="17">17</option> <option value="18">18</option> <option value="19">19</option> <option value="20">20</option> <option value="21">21</option> <option value="22">22</option> <option value="23">23</option> <option value="24">24</option> <option value="25">25</option> <option value="26">26</option> <option value="27">27</option> <option value="28">28</option> <option value="29">29</option> <option value="30">30</option> <option value="31">31</option> </select> * </td> <td>Month :</td> <td><select name="Mes" size="1" class="form01" id="Mes"> <option value="0">-----------</option> <option value="January">January</option> <option value="February">February</option> <option value="March">March</option> <option value="April">April</option> <option value="May">May</option> <option value="June">June</option> <option value="July">July</option> <option value="August">August</option> <option value="September">September</option> <option value="October">October</option> <option value="November">November</option> <option value="December">December</option> </select> * </td> <td> Year </td> <td><select name="Ano" size="1" class="form01" id="Ano"> <option value="0">------</option> <option value="2008">2008</option> <option value="2009">2009</option> <option value="2010">2010</option> </select> *</td> </tr> </table></td> </tr> <tr> <td>Comments:</td> <td bgcolor="#590000"><textarea name="Comentarios" cols="40" rows="8" class="form01" id="Comentarios"></textarea></td> </tr> <tr> <td> </td> <td bgcolor="#590000"><input name="Send" type="submit" id="Send" value="Send" /> <input name="Clear" type="reset" id="Clear" value="Clear" /></td> </tr> </table> </form></td> </tr> </table> v
