<script LANGUAGE="JavaScript">
<!--
function radiochk(r) {
myOption = -1;
if(!r.length && r.checked) {
myOption = 0;
} else {
for (j=0; j<r.length; j++) {
if (r[j].checked) {
myOption = j;
}
}
}
if (myOption == -1) {
return false;
}
return true;
}
function sprawdz(f) {
var go=true;
for (i=0;i<f.length;i++)
{
var obj=f.elements[i];
if (obj.name.substring(0,7)=='codeImg') {
if (!obj.value) {go=false;break;}
}
if (obj.name.substring(0,3)=='req') {
if ((obj.type=='text'||obj.type=='textarea')&&!obj.value) {go=false;break;}
if (obj.type.toString().charAt(0)=='s'&&!obj.selectedIndex){go=false;break;}
if (obj.type=='radio'&&!radiochk(document.f0.elements[obj.name])) {go=false;break;}
if (obj.type=='checkbox'&&!obj.checked){go=false;break;}
}
}
if (!go) {
if (obj.name.substring(0,7)=='codeImg') shortFieldName='KOD Z OBRAZKA';
else shortFieldName=obj.name.substring(3,30).toUpperCase();
alert('UWAGA ! Pole '+shortFieldName+' nie zostało poprawnie wypełnione/wybrane.');
obj.focus();
return false;
}
else
return true;
}
//
function FP_preloadImgs() {//v1.0
var d=document,a=arguments; if(!d.FP_imgs) d.FP_imgs=new Array();
for(var i=0; i<a.length; i++) { d.FP_imgs[i]=new Image; d.FP_imgs[i].src=a[i]; }
}

function FP_swapImg() {//v1.0
var doc=document,args=arguments,elm,n; doc.$imgSwaps=new Array(); for(n=2; n<args.length;
n+=2) { elm=FP_getObjectByID(args[n]); if(elm) { doc.$imgSwaps[doc.$imgSwaps.length]=elm;
elm.$src=elm.src; elm.src=args[n+1]; } }
}

function FP_getObjectByID(id,o) {//v1.0
var c,el,els,f,m,n; if(!o)o=document; if(o.getElementById) el=o.getElementById(id);
else if(o.layers) c=o.layers; else if(o.all) el=o.all[id]; if(el) return el;
if(o.id==id || o.name==id) return o; if(o.childNodes) c=o.childNodes; if(c)
for(n=0; n<c.length; n++) { el=FP_getObjectByID(id,c[n]); if(el) return el; }
f=o.forms; if(f) for(n=0; n<f.length; n++) { els=f[n].elements;
for(m=0; m<els.length; m++){ el=FP_getObjectByID(id,els[n]); if(el) return el; } }
return null;
}
-->
</SCRIPT>

<form name=f0 method="post" action="http://republika.onet.pl/webadmin_formularz.html" target="_blank" onSubmit="return sprawdz(this);">
<input type="hidden" name="id" value="3333191">
<input type="hidden" name="ret" value="6383839">
<input type="hidden" name="target" value="">
<input type="hidden" name="redirect" value="">
<input type="hidden" name="subject" value="Formularz kontaktowy">
<input type="hidden" name="adres" value="">
<div align="center">
    <table border="0" cellpadding="0" cellspacing="0" width="100%" bordercolorlight="#C0C0C0" id="table7">
        <tr>
            <td align="right"><font face="Arial">Podaj imię i nazwisko:*</font></td>
            <td> <input name="reqnazwisko" size=30 maxlenght=30></td>
        </tr>
        <tr>
            <td align="right"><font face="Arial">Podaj swój adres email:</font></td>
            <td> <input name="email" size=30 maxlenght=30></td>
        </tr>
        <tr>
            <td align="right"><font face="Arial">Podaj swój wiek:</font></td>
            <td> <select name="wiek" size="1">
<option value="0-18">0-18
<option value="19-25">19-25
<option value="26-30">26-30
<option value="ponad 30">ponad 30
</select></td>
        </tr>
        <tr>
            <td align="right"><font face="Arial">Podaj swoją płeć: </font></td>
            <td> <input type="radio" name="plec" value="kobieta" checked>kobieta <input type="radio" name="plec" value="mężczyzna">mężczyzna</td>
        </tr>
        <tr>
            <td align="right"><font face="Arial">Co sądzisz o mojej stronie?
            </font></td>
            <td> <textarea name="opinia" cols="20" rows="5"></textarea></td>
        </tr>
        <tr>
            <td align="right"><font face="Arial">Przepisz kod z obrazka</font></td>
            <td>
<IMG src="http://republika.onet.pl/myimg.gif" id="image1" border="0" style="height:50px;width:200px"><p>
<input name="codeImg" size=30 maxlenght=30></td>
        </tr>
        <tr>
            <td>&nbsp;</td>
            <td>&nbsp;</td>
        </tr>
    </table>
</div>
<p align="center">&nbsp;<input type="submit" value="wyślij"><br>
&nbsp;<br>
&nbsp;<br>
<br>
&nbsp;</p>
</form>