<vn>
<h1 id="title">
	_IWantCustomer
</h1>
<div id="main" class="contact">
	<form
		id="contact-form">
		<input type="hidden" name="srv" value="json:misc/contact"/>
	<div class="card form">
		<p>
			_FillFormData
		</p>
		<p>
			_OrCallUs
		</p>
		<div>
			<label>_Name</label>
			<input type="text" name="name"/>
		</div>
		<div>
			<label>_City</label>
			<input type="text" name="city"/>
		</div>
		<div>
			<label>_PC</label>
			<input type="text" name="pc"/>
		</div>
		<div>
			<label>_Phone</label>
			<input type="text" name="phone"/>
		</div>
		<div>
			<label>_EMail</label>
			<input type="text" name="email"/>
		</div>
		<div>
			<label>_Message</label>
			<textarea name="message"/>
		</div>
		<div class="form-group captcha">
			<label>_Anti-Spam</label>
			<input type="text" name="captcha"/>
			<img alt="Captcha" id="captcha-img"/>
		</div>
		<p class="mandatory-message">
			_AllFieldsMandatory
		</p>
		<button class="thin">
			_Send
		</button>
	</div>
	</form>
</div>
</vn>
