silakan lengkapi form berikut ini: <br/>
(Informasi selanjutnya akan dikirim ke email yang Anda masukkan)
<form name="contactform" method="post" action="http://duwur.com/e/omasae.php">
<table width="450px">
</tr>
<tr>
 <td valign="top">
  <label for="nama">Nama Anda *</label>
 </td>
 <td valign="top">
  <input  type="text" name="nama" maxlength="50" size="30">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="perusahaan">Perusahaan</label>
 </td>
 <td valign="top">
  <input  type="text" name="perusahaan" maxlength="50" size="30">
 </td>
</tr>
 
<tr>
 <td valign="top"">
  <label for="alamat">Alamat *</label>
 </td>
 <td valign="top">
  <input  type="text" name="alamat" maxlength="90" size="50">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="email">Email_Anda_*</label>
 </td>
 <td valign="top">
  <input  type="text" name="email" maxlength="80" size="30">
 </td>
 
</tr>
<tr>
 <td valign="top">
  <label for="telepon">Telepon </label>
 </td>
 <td valign="top">
  <input  type="text" name="telepon" maxlength="30" size="30">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="pesan">Pesan *</label>
 </td>
<td valign="top">
  <textarea  name="pesan" maxlength="1230" cols="56" rows="12"></textarea>
 </td>
 
</tr>
<tr>
 <td colspan="2" style="text-align:center">
  <input type="submit" value=" K i r i m ">
 </td>
</tr>
</table>
</form>