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<title>發信主機免費測試申請</title>
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<form action="http://kdm.idv.tw/f2m.php?F=1029924159" method="post">
<input type="hidden" value="大漢-主機租用" name="SOB">
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<td vAlign="top" width="393" height="1"><b>免費測試申請</b></td>
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<td align="center" width="134" bgColor="#eae8e3" height="1"><font size="2">公司名稱</font></td>
<td vAlign="top" width="393" bgColor="#eae8e3" height="1"><font size="2"><input size="25" name="公司名稱"></font></td>
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<td align="center" width="134" bgColor="#eae8e3" height="11"><font size="2">公司<span style="FONT-FAMILY: 新細明體; mso-ascii-font-family: Times New Roman; mso-hansi-font-family: Times New Roman; mso-bidi-font-family: Times New Roman; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">統編</span></font></td>
<td width="393" bgColor="#eae8e3" height="11"><font size="2"><input size="25" name="公司統編"></font></td>
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<td align="center" width="134" bgColor="#eae8e3" height="1"><font size="2">聯
絡 人</font></td>
<td width="393" bgColor="#eae8e3" height="1"><font size="2"><input size="25" name="聯 絡 人"></font></td>
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<td align="center" width="134" bgColor="#eae8e3" height="1"><font size="2">聯絡電話</font></td>
<td width="393" bgColor="#eae8e3" height="1"><font size="2">市內<input size="21" name="市內"><br>
行動<input size="21" name="行動"></font></td>
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<td align="center" width="134" bgColor="#eae8e3" height="1"><font size="2">聯絡<font face="Verdana" size="2">Mail</font></font></td>
<td width="393" bgColor="#eae8e3" height="1"><font face="Verdana" size="2"><input size="25" name="聯絡Mail"></font></td>
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<p align="center"><font size="2">公司網址</font></p>
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<td width="393" bgColor="#eae8e3" height="30"><font size="2"><input size="25" value="http://" name="公司網址"></font></td>
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<td align="center" width="134" bgColor="#eae8e3" height="30"><font size="2">連絡事項</font></td>
<td width="393" bgColor="#eae8e3" height="30"><font size="2"><textarea name="連絡事項" rows="1" cols="24"></textarea></font></td>
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<p align="left"><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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<p align="center"><font size="2">收到訊息會儘快為您服務!!</font></p>
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