<!-- Begin --------------- JS-CONTACT----------------------------
document.write('<DIV ALIGN="CENTER">');

document.write('<table CLASS="forms-inside" border="1" BORDERCOLOR="FFCC00" cellpadding="0" cellspacing="0">'); 
document.write('<tr>'); 
document.write('<form method="POST" action="http://www.poclick.com/cgi-bin/formmail.pl">'); 
document.write('<input type=hidden name="recipient" value="contact-form@poclick.com">'); 
document.write('<input type=hidden name="subject" value="POclick Management Contact Email">');
document.write('<input type=hidden name="redirect" value="http://www.poclick.com/GENERAL/contact-thanks.html">'); 

document.write('<input type=hidden name="missing_fields_redirect" value="http://www.poclick.com/errors/missing-fields.html">'); 

document.write('<input type="hidden" name="required" value="name,telephone,email,email2,details">'); 

document.write('<td>Nome / Name:</TD><td><input type="text" size="40" name="name">'); 
document.write('</TD></tr>'); 
document.write('<tr>'); 
document.write('<td>Telephone #:</TD><td><input type="text" size="15" name="telephone">'); 
document.write('</TD></tr>'); 
document.write('<tr>'); 
document.write('<td>Email:</TD><td><input type="text" size="40" name="email">');  
document.write('</TD></tr>'); 
document.write('<tr>'); 
document.write('<td >Comfirmar / Confirm Email: </TD><td><input type="text" size="40" name="email2"> '); 
document.write('</TD></tr>'); 
document.write('<tr>'); 
document.write('<TD>Comments: <BR><BR>Comentários:'); 
document.write('</TD>'); 
document.write('<td><TEXTAREA NAME="details" ROWS=4 COLS=40></TEXTAREA>'); 
document.write('</TD></tr>'); 
document.write('<tr><td></TD>'); 
document.write('<td>'); 
document.write('<input type="submit" value="Enviar / Send Email">'); 
document.write('</TD>'); 
document.write('</form>'); 
document.write('</TR></table>'); 
document.write('</DIV>');
// End ------------------------------------------------------ -->




