<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="es" lang="es">
<head>
<title></title>
<link rel="stylesheet" href="formulario.css" type="text/css" />
</head>
<body>
<div id="formulario">
<form action="" method="post" name="comentarios" >
<fieldset>
<table class="tableform">
<tr>
<td colspan="3"><legend>Datos de Contacto</legend></td>
</tr>
<tr>
<td width="60"><label for="label">Nombre:</label></td>
<td colspan="2"><input id="nick" type="text" name="nick"></td>
</tr>
<tr>
<td><label for="label">Email:</label></td>
<td colspan="2"><input id="email" type="text" name="email2"> </td>
</tr>
<tr>
<td><label for="label">Fono:</label></td>
<td colspan="2"><input id="www" type="text" name="www"></td>
</tr>
<tr>
<td colspan="3"><legend>Motivo de Consulta</legend></td>
</tr>
<tr>
<td colspan="3"><textarea id="comentario" name="comentario" cols="65" rows="6"></textarea></td>
</tr>
<tr>
<td colspan="3"><legend>Forma Contacto</legend></td>
</tr>
<tr>
<td><label for="label">Email:</label></td>
<td colspan="2"><input name="fono" type="checkbox" disabled="" value="" class="checkbox"/></td>
</tr>
<tr>
<td><label for="fono">Fono:</label></td>
<td width="74"><input name="email" type="checkbox" disabled="" value="" class="checkbox" /></td>
<td width="414"><input name="submit" type="submit" class="submit" value="Enviar" /></td>
</tr>
<tr>
<td colspan="3"><div id="pie">
<table class="tableconsulta">
<tr>
<td width="531"><p>Para consultas pueden dirigirse </p></td>
</tr>
</table>
</div></td>
</tr>
</table>
<input class="no_style" type="hidden" name="id" /><br />
</fieldset>
</form>
</div>
</body>
</html>