document.write('<form method="POST" action="/cgi-sys/formmail.pl"><input type="hidden" name="recipient" value="recarra@libero.it"><input type="hidden" name="redirect" value="http://www.cosecosi.com/website/grazie/contatta.htm"><table border="0" width="150" cellspacing="0" cellpadding="0"><tr><td width="100%" align="center"><font face="Verdana" size="1">E-Mail</font></td></tr><tr><td width="100%" align="center"><font face="Verdana" size="1"><input type="text" name="email" size="13"></font></td></tr><tr><td width="100%" align="center"></td></tr><tr><td width="100%" align="center"><font face="Verdana" size="1"><input type="checkbox" name="motivo" value="ho dei prodotti" checked>Vorrei essere contattato per prodotti della categoria:</font></td></tr><tr><td width="100%" align="center"><font face="Verdana" size="1"><img src="../shim.gif" width="1" height="3" alt="shim.gif (43 byte)"></font></td></tr><tr><td width="100%" align="center"><font face="Verdana" size="1"><select name="D1" size="1"><option value="---------------">----------------</option><option value="casa">casa</option><option value="lavoro">lavoro</option><option value="persona">persona</option><option value="tempolibero">T.Libero</option></select></font></td></tr><tr><td width="100%" align="center"><font face="Verdana" size="1"><img src="../shim.gif" width="1" height="3" alt="shim.gif (43 byte)"></font></td></tr><tr><td width="100%" align="center"><input type="submit" value="contattatemi" name="azione"></td></tr></table></form>')