<form method="post" action="">
<p><img src="img/logo-color.bmp"></p>
<table width="861" border="1" align="center" cellpadding="0" cellspacing="0" bordercolor="#FFFFFF" bgcolor="#FFFFFF">
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<td valign="middle" nowrap><p> <font color="#000" size="5" face="Arial, Helvetica, sans-serif">Cotação On-Line</font></p></td>
<td width="301"> </td>
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</table>
<table width="855" border="1" align="center" cellpadding="0" cellspacing="0" bordercolor="#FFFFFF" bgcolor="#FFFFFF">
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<td width="838" valign="middle" nowrap bordercolor="#FFFFFF"><p align="left"> <font face="Arial, Helvetica, sans-serif">Preencha o formulário abaixo para que possamos elaborar uma cotação de acordo com suas necessidades.<br>
Caso não possua todas as informações, não se preocupe. Assim que recebermos sua solicitação entraremos em contato. </font></p></td>
<td width="11"><div align="left"></div></td>
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</table>
<p> </p>
<table width="733" border="1" align="center" cellpadding="0" cellspacing="0" bordercolor="#FFFFFF" bgcolor="#FFFFFF">
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<h1 align="center"></h1>
<h5 align="center"></h5>
<?php
if (isset($_POST['enviar']))
{
print "<h4 align=\"center\">A mensagem foi enviada!!!</h4>";
}
?>
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<tr>
<td valign="middle" nowrap><p><strong><font color="#000" size="3" face="Arial, Helvetica, sans-serif">Dados do Solicitante</font></strong></p></td>
<td> </td>
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<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Nome:</font></strong></p></td>
<td width="301">
<input type="text" name="Nome" size="60"></td>
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<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">CPF / CNPJ:</font></strong></p></td>
<td width="301">
<input type="text" name="CPF / CNPJ:" size="60"></td>
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<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Contato:</font></strong></p></td>
<td width="301">
<input type="text" name="Contato" size="60"></td>
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<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Endereço:</font></strong></p></td>
<td width="301">
<input type="text" name="Endereco" size="60"></td>
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<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">E-mail:</font></strong></p></td>
<td>
<input type="text" name="E-mail" size="60"></td>
</tr>
<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Telefone:</font></strong></p></td>
<td width="301">
<input type="text" name="Telefone" size="60"></td>
</tr>
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<td valign="middle" nowrap>
<p> <strong><font size="3" face="Arial, Helvetica, sans-serif"> <br>
Informações sobre a Carga </font></strong></p></td>
<td width="301"></td>
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<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Cidade Origem:</font></strong></p></td>
<td width="301">
<input type="text" name="Cidade Origem" size="60"></td>
</tr>
<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Cidade Destino:</font></strong></p></td>
<td width="301">
<input type="text" name="Cidade Destino" size="60"></td>
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<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Tipo do Material:</font></strong></p></td>
<td width="301">
<input type="text" name="Tipo do Material" size="60"></td>
</tr>
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<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Quantidade(un):</font></strong></p></td>
<td width="301">
<input type="text" name="Quantidade(un)" size="17"></td>
</tr>
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<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Peso Total(kg):</font></strong></p></td>
<td>
<input type="text" name="Peso Total(kg)" size="17"></td>
</tr>
<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Valor da Nota Fiscal(R$):</font></strong></p></td>
<td width="301">
<input type="text" name="Valor da Nota Fiscal(R$)" size="17"></td>
</tr>
<tr>
<td valign="middle" nowrap>
<p> <strong><font size="3" face="Arial, Helvetica, sans-serif"><br>
Dimensões</font></strong></p></td>
<td width="301"></td>
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<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Altura:</font></strong></p></td>
<td width="301">
<input type="text" name="Altura" size="17"></td>
</tr>
<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Largura:</font></strong></p></td>
<td width="301">
<input type="text" name="Largura" size="17"></td>
</tr>
<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Comprimento:</font></strong></p></td>
<td width="301">
<input type="text" name="Comprimento" size="17"></td>
</tr>
<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Tipo de Transporte:</font></strong></p></td>
<td>
<select name="Tipo de Transporte:">
<option value="Aéreo" selected>Aéreo</option>
<option value="Rodoviário">Rodoviário</option>
</select></td>
</tr>
<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Observações:</font></strong></p></td>
<td>
<textarea name="Observacoes" cols="80" rows="4"></textarea></td>
</tr>
<tr>
<td valign="middle" nowrap><p><strong><font size="3" face="Arial, Helvetica, sans-serif"> <br>
Informações Adicionais </font></strong></p></td>
<td> </td>
</tr>
<tr>
<td valign="middle" nowrap>
<p>
<strong><font color="#000" size="2" face="Arial, Helvetica, sans-serif">Como conheceu a MSJ:</font></strong></p></td>
<td>
<select name="Como conheceu a MSJ">
<option value="Site de busca" selected>Site de busca</option>
<option value="Indicação">Indicação</option>
<option value="Anúncios">Anúncios</option>
<option value="Frota">Frota</option>
<option value="E-mail Marketing">E-mail Marketing</option>
<option value="Outros">Outros</option>
</select></td>
</tr>
<tr>
<td colspan="2" valign="middle">
<strong><font size="2" face="Arial, Helvetica, sans-serif"><br>
</font></strong>
<div align="center">
<strong><font size="2" face="Arial, Helvetica, sans-serif">
<input type="submit" name="enviar" value="enviar">
<input type="reset" name="limpar" value="limpar">
</font></strong></div></td>
</tr>
</table>
</form>
YGN TRANSPORTES
YGN TRANSPORTES
Rua :Thomaz Fimiani , 266
Cep:06273-010
Bairro: Vila Clarisse
Osasco- SP
Telefones: (11) 3659-5804 /(11) 9 6455-8210
E-mail:Vanessa.ygn@hotmail.com