</ title>
<'text / javascript' script type = src = 'http://www.form2go. com/publish/validation_js/52272 '>
</ script>
<link rel="stylesheet" type="text/css" href="http://www.form2go.com/css/forms/publish.css" />
<link rel="stylesheet" type="text/css" href="http://www.form2go.com/publish/script_css/52272" />
<style type="text/css">
/ * <! [ CDATA [* /
# form_body {
background-image: url (''); background-color: # ffffff;
margin-bottom: 0 importante ";
} . form2go_link_in_footer { color: # ffffff; float: right; line-height: 14px; font-size: 10px; text-decoration: none importante;! cursor: pointer; } . footer-obligatoria { float: right; color: # 000000 importantes; font-family: Arial, Helvetica, sans-serif; fuente -size: 10px; margin:-25px 2px importante;! padding: 6px importante;! min-height: 14px importante;! text-decoration: none importante;! } # form-main-container, # forma de tabla 15px auto; position: relative; } # form-main-container h1 { display: none; fondo: # 2E8ABF; font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: bold; fuente -size: 18px; line-height: 18px; color: # FFFFFF; padding: 8px importante;! margen: 0px; } # form-main-contenedor h2 { display: none; fondo: # 2E8ABF; font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: normal; font-size: 12px; line-height: 12px; color: # FFFFFF; padding: 6px importante;! margen: 0px; } real-encabezamiento. { font-size: 18px; line-height: px; font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: normal; color: # 000000; position: relative; padding-bottom: 10px; margen: 0px; } . real-sub-encabezamiento { font-size: 12px; line-height: px; font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: normal; color: # 000000; position: relative; padding-bottom: 10px; margen: 0px; } . real-forma { padding: 0px importante; } . actual_label { font-family: Arial, Helvetica, sans-serif; font-style : normal; font-weight: bold; font-size: 12px; line-height: 18px; color: # 000000; margin: 0 5px 0 0; } .. todos a revisar palmo, todo-radio lapso { font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: normal; font-size: 12px; line-height: 18px; color: # 000000; margin: 0 15px 0 0; } {sub-etiqueta. font-family: Arial, Helvetica, sans-serif; font-style: italic; font-weight: normal; font-size: 10px; line-height: 16px; color: # 000000; } . real-fields { list-style tipo: none; margin: 0; padding: 15px 0; } . real-campos de etiqueta { ancho: 150px; text-align: left; display: block; float: left; padding: 0 1px; } . real-campos li { margen: 2px 0; padding: 15px 8px; } . único campo { padding: 0px; } . formBtnContainerPreview { display: block; margin: 0; padding: 7px 0; text-align: center; width: 100%; } solo campo textarea {. font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: input [type = text] { font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: seleccionar { font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: . Fld_err { ! background-color: # FFDBDB importante; border: 1px solid # FFB7B7; } . real-campos. err_span { font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: bold ; font-size: 12px; line-height: px; color: # D62828; fondo: url ('http://www.form2go.com/images/span_error.gif') no-repeat scroll transparente centro izquierda; margen: 5px 0; padding: 18px 1px 1px 1px; display: block; } . punta-a-focus { font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: { font-family: Arial, Helvetica, sans-serif; font-style: normal; font-weight: normal; font-size: 11px; line-height: px; color: # 999999; display: block; padding: 5px 5px 5px 0; } .. tip-abajo-field tool_tip_text { } / *]]> * / </ style> </ head> <body id="form_body"> <div id="form-main-container"> < div class = "actual forma"> Messenger type='text/javascript'> / / <! [CDATA [ $ (document). ready (function () { $ ('. real-campos li'). cada una ( function () { if ($ (this) attr ('rel') == 'Tag5' |. |. $ (this) attr ('rel') == 'Tag6') { $ ('# form2go_form tabla tbody tr ') encontrar. (' td color ',' # 000000 ') css ('. '); } else if ($ (this). attr ('rel') == 'Tag13') { . $ (this) encuentran . ('. único campo') css ('color', '# 000000'); } }); }); / /]]> </ script> <nombre del formulario = 'frm_52272 "action =" http:/ / www.form2go.com/publish/publish_form/52272 "method =" post "id =" form2go_form 'enctype = "multipart / form-data"> <input type = "hidden" name = "form_id" valor = '52272 ' /> name='captcha_hidden' type='hidden' value='1' <input /> <ul class='actual-fields'> <li id='li-50a610a65bed0' rel='Tag13'> <div class = 'single-field'> <h3 class='actual-heading'> en contacto con nosotros </ h3> <p class='actual-sub-heading'> </ p> <div style='clear:both'> <! ----> </ div> </ div> </ li> <li id='li-50a610a65bae9' rel='Tag8'> <div class='single-field'> <div class = 'real-campos -label '> <span class='actual_label'> Nombre Completo </ span> <span class='fld-required' style='display:none'> * </ span> </ div> <= '0 borde de la tabla "cellpadding = 0" cellspacing = 0 "width = '315px" style = "float: left '> <tr> <td class='hide-prefix actual-prefix'> <div style='position:relative'> <span class='sub-label-container'> type='text' <input size='3' name='50a610a65bae9_1' id='50a610a65bae9_1' value='' /> <label class='sub-label'> Prefijo </ label> </ span> </ div> </ td> <td> <div style='position:relative'> <span class='sub-label-container'> <input type = 'text' tamaño = '16 'name = '50a610a65bae9_2' id = '50a610a65bae9_2 "valor ='' /> <label class='sub-label'> Nombre </ label> </ span> </ div> </ td> <td "hide-medio-medio real 'class => <div style='position:relative'> <span class='sub-label-container'> <input type = 'text' size = '14 'name = '50a610a65bae9_3' id = '50a610a65bae9_3 "valor ='' /> <label class='sub-label'> Segundo Nombre </ label> </ span> </ div> </ td> <td> <div style = "position: relative '> <span class='sub-label-container'> type='text' <input size='16' value='' id='50a610a65bae9_4' name='50a610a65bae9_4' /> <class = etiqueta 'sub-etiqueta '> Nombre </ label> </ span> </ div> </ td> </ tr> </ table> <div style='clear:both'> <! ----> </ div> < / div> </ li> <li id='li-50a610a65c2ba' rel='Tag7'> <div class='single-field'> <div class='actual-fields-label'> <span class = 'actual_label '> Dirección de correo electrónico </ span> <span class='fld-required' style='display:none'> * </ span> </ div> <div class='email-field-container'> <div style = "position: relative '> <span class='sub-label-container'> type='text' <input class='fld-medium' id='50a610a65c2ba' name='50a610a65c2ba' value='' /> <etiqueta class = 'sub-etiqueta'> por ejemplo. xyz@domain.com </ label> </ span> </ div> </ div> <div style='clear:both'> <! ----> </ div> </ div> </ li> <li id='li-50a610a65c6a0' rel='Tag1'> <div class='single-field'> <div class='actual-fields-label'> <span class = 'actual_label'> Company </ span> <span class='fld-required' style='display:none'> * </ span> </ div> <input type = "text" name = '50a610a65c6a0 "valor = '' id = '50a610a65c6a0 'size = maxlength'' ='' class =' fld-large actual_default '/> <div style='clear:both'> <! ----> </ div> </ div> </ li> <li id='li-50a610a65ca88' rel='Tag9'> <div class='single-field'> <div class='actual-fields-label'> <span Dirección class='actual_label'> </ span> <span class='fld-required' style='display:none'> * </ span> </ div> <borde de la tabla = '0 'cellpadding = 0 "cellspacing = 0" width = " 'style =' 315px float: left "> <tr> <td class='show-address1 actual-address1' colspan='2'> <div style='position:relative'> <span class = 'sub-label- contenedor '> type='text' <input class='fld-extra-large' id='50a610a65ca88_1' name='50a610a65ca88_1' value='' /> <label class='sub-label'> Dirección Línea 1 </ label> </ span> </ div> </ td> </ tr> <tr> <td class='show-address2 actual-address2' colspan='2'> <div style='position:relative'> < 'sub-label-contenedor "span class => <input type='text' class='fld-extra-large' id='50a610a65ca88_2' name='50a610a65ca88_2' value='' /> <class = etiqueta' sub- etiqueta '> Dirección Línea 2 </ label> </ span> </ div> </ td> </ tr> <tr> <td class='show-city actual-city'> <div style = "position: relative '> <span class='sub-label-container'> type='text' <input class='fld-medium' id='50a610a65ca88_3' name='50a610a65ca88_3' value='' /> <class = etiqueta 'sub -label '> Ciudad </ label> </ span> </ div> </ td> <td class='show-state actual-state'> <div style='position:relative'> <span class = 'sub -label-contenedor '> type='text' <input class='fld-medium' value='' id='50a610a65ca88_4' name='50a610a65ca88_4' /> <label class='sub-label'> Estado </ label > </ span> </ div> </ td> </ tr> <tr> <td class='show-zipcode actual-zipcode'> <div style='position:relative'> <span class = 'sub- etiqueta del contenedor '> <input type='text' class='fld-medium' value='' name='50a610a65ca88_5' id='50a610a65ca88_5' /> <label class='sub-label'> Zip Code </ etiqueta > </ span> </ div> </ td> <td class='show-country actual-country'> <div style='position:relative'> <span class='sub-label-container'> <input type = 'text' class = 'fld-medio "name = '50a610a65ca88_6' id = '50a610a65ca88_6" valor ='' /> <label class='sub-label'> País </ label> </ span> </ div > </ td> </ tr> </ table> <div style='clear:both'> <! ----> </ div> </ div> </ li> <li id = 'li-50a610a65ce70 'rel =' Tag12 '> <div class='single-field'> <div class='actual-fields-label'> <span class='actual_label'> número de teléfono </ span> <span class = 'fld- 'style =' required display: none "> * </ span> </ div> <div id='3-box' class='actual-phone'> <span class='sub-label-container'> <input type = "text" name = '50a610a65ce70_1 'id = '50a610a65ce70_1 "valor ='' class =" teléfono-3-box número único "maxlength = '3' title = First 'Tres Números' /> <class = etiqueta ' 'style =' sub-etiqueta text-align: center; "> # # # </ label> </ span> <span class='sub-label-container'> <input type =" text "name = '50a610a65ce70_2 ' id = '50a610a65ce70_2 "valor ='' class =" teléfono-3-box número único "maxlength = '3 'title =' Second Tres Números '/> <class = estilo etiqueta' sub-label '=' text-align : center; "> # # # </ label> </ span> <span class='sub-label-container'> <input type = "text" name = '50a610a65ce70_3 'id = '50a610a65ce70_3 "valor ='' clase = 'teléfono-3-box número único "maxlength = '4' title =" Últimos Cuatro Números '/> <label class='sub-label' style='text-align:center;'> # # # # < / label> </ span> </ div> <div style='clear:both'> <! ----> </ div> </ div> </ li> <li id = 'li-50a610a65d258' rel = 'Tag2'> <div class='single-field'> <div class='actual-fields-label'> <span class='actual_label'> comentario </ span> <span class = 'fld requerido por el "estilo 'display: none' => * </ span> </ div> <textarea name = '50a610a65d258 'id = '50a610a65d258 "cols = '40' filas = '5 'class =' actual_default 'style =' resize: none ' > </ textarea> <div style='clear:both'> <! ----> </ div> </ div> </ li> <li style="list-style: none; display: inline"> <script type="text/javascript"> / / <[CDATA [! (function ($) { $ (document) ready (function () {. }); }) (jQuery); / /]]> </ script> <script type="text/javascript"> / / <! [CDATA [ document.write ('type=\'hidden\' <input value='+window.location+'> name=\'CurrURL\'' ) / /]]> </ script> </ li> <li style='position:static'> <div class='formBtnContainerPreview fltlft'> <span class='dont-move'> <input type = "submit" id = 'form2go_submit' class = 'submitBtn' value = "Enviar" /> </ span> </ div> <p class='clear'> </ p> </ li> </ ul> <div class 'footer-obligatoria' => <a style = 'text-decoration: none importante; color:! # 000000 importantes,' title = 'Powered by Form2go' href = 'http://www.form2go.com "name = 'form2go_link_in_footer' id = 'form2go_compulsory'> Powered by Form2go </ a> </ div> </ form> </ div> </ div> </ body> </ html>
</body>
</html>
