De TeHospedia
<html>
<head>
<title>Formulário</title>
<meta http-equiv="Content-Type" content="text/html;">
<style>
.texto {font: 13px Verdana; text-decoration: none; color: #000000}
.texto_peq {font: 11px Verdana; text-decoration: none; color: #000000}
.titulos {font: bold 13px Verdana; text-decoration: none; color: #000000}
.form_campos {background-color: #FFFFFF; font: 12px Verdana; border-style: groove}
.form_botao {background-color: #CCCCCC; font: 12px Verdana; border-style: outset}
</style>
</head>
<body bgcolor="#FFFFFF" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0">
<br>
<center><font class="titulos">Formulário</font></center>
<form name="formulario" method="post" action="formmail.php">
<table width="100" border="0" cellspacing="0" cellpadding="0" align="center">
<tr bgcolor="#F4F4F4">
<td valign="top" width="100" nowrap><font class="texto">Nome:</font></td>
<td>
<input class="form_campos" type="text" name="nome" size="34">
</td>
</tr>
<tr bgcolor="#EFEFEF">
<td valign="top" width="100" nowrap><font class="texto">Cidade</font></td>
<td>
<input class="form_campos" type="text" name="cidade" size="20">
</td>
</tr>
<tr bgcolor="#F4F4F4">
<td valign="top" width="100" nowrap><font class="texto">Estado:</font></td>
<td>
<select class="form_campos" name="estado">
<!-- <option value="" selected></option> -->
<option value="AC">AC</option>
<option value="AL">AL</option>
<option value="AM">AM</option>
<option value="AP">AP</option>
<option value="BA">BA</option>
<option value="CE">CE</option>
<option value="DF">DF</option>
<option value="ES">ES</option>
<option value="GO">GO</option>
<option value="MA">MA</option>
<option value="MG">MG</option>
<option value="MT">MT</option>
<option value="MS">MS</option>
<option value="PA">PA</option>
<option value="PB">PB</option>
<option value="PE">PE</option>
<option value="PI">PI</option>
<option value="PR">PR</option>
<option value="RJ">RJ</option>
<option value="RN">RN</option>
<option value="RO">RO</option>
<option value="RR">RR</option>
<option value="RS">RS</option>
<option value="SC">SC</option>
<option value="SE">SE</option>
<option value="SP">SP</option>
<option value="TO">TO</option>
</select>
</td>
</tr>
<tr bgcolor="#EFEFEF">
<td valign="top" width="100" nowrap><font class="texto">E-mail:</font></td>
<td>
<input class="form_campos" type="text" name="email" size="34">
</td>
</tr>
<tr bgcolor="#F4F4F4">
<td valign="top" width="100" nowrap><font class="texto">Assunto:</font></td>
<td>
<select class="form_campos" name="assunto_mensagem">
<option value="Opinião" selected>Opinião</option>
<option value="Sugestão">Sugestão</option>
<option value="Parceria">Parceria</option>
<option value="Reclamação">Reclamação</option>
<option value="Sem assunto">Outros</option>
</select>
</td>
</tr>
<tr bgcolor="#EFEFEF">
<td valign="top" width="100" nowrap><font class="texto">Mensagem:</font></td>
<td>
<textarea class="form_campos" name="mensagem" cols="34" rows="4"></textarea>
</td>
</tr>
<tr bgcolor="#F4F4F4">
<td colspan="2" valign="middle">
<!-- <font class="texto">* campos obrigatório</font> -->
<br>
<div align="center">
<input class="form_botao" type="submit" name="Enviar" value="Enviar Mensagem">
<input class="form_botao" type="reset" name="Limpar" value="Limpar">
</div>
</td>
</tr>
</table>
</form>
<body>
</html>
