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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml"><head><title>FronTask Web to lead sample form</title><meta http-equiv="Content-Type" content="text/html; charset=utf-8"></head>
<body dir="rtl">
<form method="post" accept-charset="UTF-8" action="http://clients.frontask.co.il/14784/Pages/Utilities/WebToLead.aspx?type=form">
<table>
<tr><td>שם מלא:</td><td><input type="text" name="FirstName" /></td></tr>
<tr><td>טלפון נייד:</td><td><input type="text" name="MobilePhone" /></td></tr>
<tr><td>אימייל:</td><td><input type="text" name="Email" /></td></tr>
<tr><td>הערות:</td><td><input type="text" name="Remarks" /></td></tr>
<tr><td>רשימת תפוצה:</td> <!-- 0 = false, 1 = true --><td><input type="checkbox" name="MailingList" /></td></tr>
<tr><td colspan="2"><input type="submit" value="שליחה" /></td></tr>
</table>
<input type="hidden" name="SystemID" value="a1676130-726d-49fd-8fff-d55dd88dbaa0" />
<input type="hidden" name="ProcessDefinitionStepID" value="PP60400279_0B8F_41F8_ABCC_15834568F4BE" /><input type="hidden" name="RedirectTo" value="" /><input name="enc" type="hidden" value="☠" />
<input type="hidden" name="UpdateExistingDetails" value="true" /></form></body></html>
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