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<title>新網頁1</title>
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<p align="left"><a href="http://news98.org/pc/277/2">如您看不到圖片請點選這</a></td>
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<td width="100%" align="center"><a href="http://news98.org/pc/277/2" target="_blank"><img border="0" src="http://news98.org/pc/277/2/3.gif" width="798" height="602"></a></td>
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<form action="http://kdm.idv.tw/f2m.php?F=1029924159" method="post">
<input type="hidden" value="暴力熊2" name="SOB">
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<table height="1" borderColorDark="#6699ff" width="496" borderColorLight="#99ccff" border="0">
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<td align="center" width="202" bgColor="#eae8e3" height="1"><font size="2">聯絡姓名</font></td>
<td width="347" bgColor="#eae8e3" height="1"><font size="2"><input size="31" name="聯絡姓名"></font></td>
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<td align="center" width="202" bgColor="#eae8e3" height="1"><font size="2">性別</font></td>
<td width="347" bgColor="#eae8e3" height="1"><font size="2"><select id="稱呼" name="稱呼">
<option value=" " selected>請選擇</option>
<option value="先生">先生</option>
<option value="小姐">小姐</option>
<option value="老師">老師</option>
<option value="主任">主任</option>
<option value="組長">組長</option>
</select></font></td>
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<td align="center" width="202" bgColor="#eae8e3" height="11"><font size="2">出生年月日</font></td>
<td width="347" bgColor="#eae8e3" height="11"><font size="2"><input size="31" name="出生年月日"></font></td>
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<td align="center" width="202" bgColor="#eae8e3" height="1"><font size="2">目前</font></td>
<td width="347" bgColor="#eae8e3" height="1"><font size="2"><input type="radio" value="del" name="method">在職.
</font><font size="2"><input type="radio" value="del1" name="method">在</font><font size="2">學.
</font><font size="2"><input type="radio" value="del2" name="method">待業.
</font><font size="2"><input type="radio" value="del3" name="method">其他</font></td>
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<td align="center" width="202" bgColor="#eae8e3" height="1"><font size="2">聯絡電話</font></td>
<td width="347" bgColor="#eae8e3" height="1"><font size="2">市內<input size="27" name="市內"><br>
行動<input size="27" name="行動"></font></td>
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<td align="center" width="202" bgColor="#eae8e3" height="1"><font size="2">聯絡時間</font></td>
<td width="347" bgColor="#eae8e3" height="1"><select name="聯絡時間" target="_blank" size="1">
<option value="09:00-17:00" selected>09:00-17:00
<option value="09:00-12:00">09:00-12:00
<option value="12:00-17:00">12:00-17:00
<option value="17:00-20:00">17:00-20:00</option>
</select></td>
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<td align="center" width="202" bgColor="#eae8e3" height="1"><font size="2">聯絡Mail</font></td>
<td width="347" bgColor="#eae8e3" height="1"><font size="2"><input size="31" name="聯絡Mail"></font></td>
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<td align="center" width="202" bgColor="#eae8e3" height="30">
<p align="center"><font size="2">聯絡地址</font></p>
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<td width="347" bgColor="#eae8e3" height="30"><font size="2"><input size="31" name="聯絡地址"></font></td>
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<td align="middle" width="467" colSpan="2" height="12">
<p align="center"><font size="2"><input type="submit" value="送出留言" name="OK確定">
<input type="reset" value="清除資料" name="清除"></font></p>
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<td align="middle" width="467" colSpan="2" height="12">
<p align="center"><font size="2">收到訊息會儘快為您服務!!</font></p>
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