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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.1//EN" "http://www.w3.org/TR/xhtml11/DTD/xhtml11.dtd">
<html xmlns='http://www.w3.org/1999/xhtml'>
   <head >
      <meta http-equiv='Content-Type' content='text/html; charset=utf-8'/>
      <title >Form Page: Rugaciune</title>
      <meta name='generator' content='Simfatic Forms 4.0.12.416'/>
      <script src='scripts/jquery-1.7.2.min.js' type='text/javascript'></script>
      <script src='scripts/sfm-png-fix.js' type='text/javascript'></script>
      <script src='scripts/jquery.sim.utils.js' type='text/javascript'></script>
      <script src='scripts/sfm_validatorv7.js' type='text/javascript'></script>
      <link rel='stylesheet' type='text/css' href='style/Rugaciune.css?r=1328480905'/>
   </head>
   <body id='sfm_Rugaciune_body'>
      <form id='Rugaciune' class='sfm_form' method='post' action='/forms/Rugaciune/Rugaciune.php?sfm_sid=' accept-charset='UTF-8'>
         <div id='Rugaciune_errorloc' class='error_strings' style='width:339px;text-align:left'></div>
         <div id='Rugaciune_outer_div' class='form_outer_div' style='width:339px;height:380px'>
            <div style='position:relative' id='Rugaciune_inner_div'>
               <input type='hidden' name='sfm_form_submitted' value='yes'/>
               <input type='hidden' name='id_1cdc52b010493532cec3' value='e6238a7113a8a8388328fcb09'/>
               <input type='text' name='t2ca2fadb30d2fc1660dd' id='t2ca2fadb30d2fc1660dd'/>
               <div id='heading_container' class='form_subheading'>
                  <h2 id='heading' class='form_subheading'>Cerere de Rugaciune</h2>
               </div>
               <div id='Image_container'>
                  <img class='sfm_image_in_form' src='images/contact-us-2-1.jpg' width='96' height='64' alt=''/>
               </div>
               <div id='TextBlock_container' class='sfm_form_label'>
                  <label id='TextBlock' for='Name'>Numele si Prenumele*</label>
               </div>
               <div id='Name_container'>
                  <input type='text' name='Name' id='Name' value='' size='20' class='sfm_textbox'/>
               </div>
               <div id='TextBlock1_container' class='sfm_form_label'>
                  <label id='TextBlock1' for='Email'>Adresa de  e-mail*</label>
               </div>
               <div id='Email_container'>
                  <input type='text' name='Email' id='Email' value='' size='20' class='sfm_textbox'/>
               </div>
               <div id='label3_container' class='sfm_form_label'>
                  <label id='label3' for='Message'>Va rog sa va rugati pentru:</label>
               </div>
               <div id='Message_container'><textarea name='Message' id='Message' cols='50' rows='10' class='sfm_textarea'></textarea></div>
               <div id='Trimite_container' class='loading_div'>
                  <input type='image' name='Trimite' id='Rugaciune_Trimite_img' src='images/contact_us-Submit-1.png' alt='submit'/>
               </div>
            </div>
         </div>
<div class='sfm_cr_box' style='padding:3px; width:350px;cursor:default'>Web form built with <a style='text-decoration:none;' rel='nofollow' href='http://www.simfatic.com'>Simfatic Forms web form builder</a>.</div>
      </form>
      <script type='text/javascript'>
// <![CDATA[
$(function()
{
   sfm_show_loading_on_formsubmit('Rugaciune','Rugaciune_Trimite_img');
});
sfm_fix_png("Rugaciune_Trimite_img","images/spacer.gif");

// ]]>
      </script>
      <script type='text/javascript'>
// <![CDATA[
var RugaciuneValidator = new Validator("Rugaciune",{enable_smart_live_validation:false});
RugaciuneValidator.addValidation("Name",{required:true,message:"Te rugam scrie Numele si Prenumele"} );
RugaciuneValidator.addValidation("Name",{maxlen:"50",message:"The length of the input for Name should not exceed 50"} );
RugaciuneValidator.addValidation("Email",{email:true,message:"The input for Email should be a valid email value"} );
RugaciuneValidator.addValidation("Email",{required:true,message:"Te rugam adauga adresa ta de E-mail"} );
RugaciuneValidator.addValidation("Email",{maxlen:"50",message:"The length of the input for Email should not exceed 50"} );
RugaciuneValidator.addValidation("Message",{maxlen:"102400",message:"The length of the input for Message should not exceed 102400"} );
RugaciuneValidator.addValidation("Message",{required:true,message:"Te rugam completeaza mesajul"} );

// ]]>
      </script>
   </body>
</html>