<script src="http://jotform.com/js/form.js?v2.0.796" type="text/javascript"></script>
<style type="text/css">html,body{height:100%; margin:0;}
.tbmain{
/* Changes on the form */
background: url(http://jotform.com/images/styles/style4_2_bg.gif) #363535 top repeat-x !important;
}
.left{
/* Changes on the form */
color: #cccccc !important;
font-family: Verdana !important;
font-size: 12px !important;
}
td.left {
font-family: "Trebuchet MS";
font-size: 12px;
font-weight:normal;
color:#cccccc;
vertical-align: top;
text-align: left;
}
.pagebreak{
font-family: "Trebuchet MS";
font-size: 12px;
font-weight:bold;
color:black;
}
td.right {
font-family: "Trebuchet MS";
font-size: 12px;
font-weight:normal;
color:#cccccc;
vertical-align: top;
text-align: left;
}
.tbmain{
height:100%;
color:#cccccc;
background:url(http://jotform.com/images/styles/style4_2_bg.gif) #363535 top repeat-x;
}
.head{
font-family: "Trebuchet MS";
font-size: large;
font-weight:bold;
color:#ffffff;
vertical-align: top;
text-align: left;
}
.notvalid{
border:2px red solid;
font-family:"Trebuchet MS";
}
.text{
font-family: "Trebuchet MS";
font-size: 12px;
font-weight:normal;
color:#cccccc;
border:1px #000000 solid;
background:url(http://jotform.com/images/styles/style4_txt_bg.gif) #333333 top repeat-x;
}
select.other{
font-family: "Trebuchet MS";
font-size: 12px;
font-weight:normal;
color:#ffffff;
border:1px #000000 solid;
background:url(http://jotform.com/images/styles/style4_txt_bg.gif) #333333 top repeat-x;
}
.btn{
font-family: "Trebuchet MS";
font-size: 12px;
font-weight:normal;
color:#cccccc;
border:1px #000000 solid;
background: url(http://jotform.com/images/styles/style4_btn_bg.gif) #333333 top repeat-x;
}
span.required{
font-size: 13px !important;
color: red !important;
}
div.backButton{
background: transparent url("http://jotform.com//images/btn_back.gif") no-repeat scroll 0 0;
height:16px;
width:53px;
float:left;
margin-bottom:15px;
padding-right:5px;
}
div.backButton:hover{
background: transparent url("http://jotform.com//images/btn_back_over.gif") no-repeat scroll 0 0;
}
div.backButton:active{
background: transparent url("http://jotform.com//images/btn_back_down.gif") no-repeat scroll 0 0;
}
div.nextButton{
background: transparent url("http://jotform.com//images/btn_next.gif") no-repeat scroll 0 0;
height:16px;
width:53px;
float: left;
margin-bottom:15px;
padding-right:5px;
}
div.nextButton:hover{
background: transparent url("http://jotform.com//images/btn_next_over.gif") no-repeat scroll 0 0;
}
div.nextButton:active{
background: transparent url("http://jotform.com//images/btn_next_down.gif") no-repeat scroll 0 0;
}
.pageinfo{
padding-right:5px;
margin-bottom:15px;
float:left;
}
</style>
</head>
<body>
<table width="100%" cellpadding="2" cellspacing="0" class="tbmain">
<tr><td class="topleft" width="10" height="10"> </td>
<td class="topmid"> </td>
<td class="topright" width="10" height="10"> </td>
</tr>
<tr>
<td class="midleft" width="10"> </td>
<td class="midmid" valign="top">
<form action="http://jotform.com/submit.php" method="post" name="q_form_83251049752">
<input type="hidden" name="formID" value="83251049752" />
<div id="main">
<div class="pagebreak">
<table width="520" cellpadding="5" cellspacing="0">
<tr >
<td colspan="2" class="left" >
Aşağıdaki ÜyeLik Formunuzu Doldurunuz.Sitemize Kayıt oLabilmek için GerekLi yerLeri Doldurunuz.Ve Site sahibi Tarafından Onaylanacak Size Mail İle haber VeriLecektir.
</td>
</tr>
<tr >
<td width="150" class="left" >
<label >Ad Soyad *</label>
</td>
<td class="right" >
<input type="text" size="20" name="q8_AdSoyad" class="text" value="" id="q8" maxlength="100" maxsize="100" />
</td>
</tr>
<tr >
<td width="150" class="left" >
<label >Mail Adresin *</label>
</td>
<td class="right" >
<input type="text" size="20" name="q10_MailAdresin" class="text" value="" id="q10" maxlength="100" maxsize="100" />
</td>
</tr>
<tr >
<td width="150" class="left" >
<label >Şifre *</label>
</td>
<td class="right" >
<input type="text" size="20" name="q11_ifre" class="text" value="" id="q11" maxlength="100" maxsize="100" />
</td>
</tr>
<tr >
<td width="150" class="left" >
<label >Şifreni TekrarLa *</label>
</td>
<td class="right" >
<input type="text" size="20" name="q12_ifreniTekrarLa" class="text" value="" id="q12" maxlength="100" maxsize="100" />
</td>
</tr>
<tr >
<td width="150" class="left" >
<label >Siten *</label>
</td>
<td class="right" >
<input type="text" size="20" name="q9_Siten" class="text" value="" id="q9" maxlength="100" maxsize="100" />
</td>
</tr>
<tr >
<td width="150" class="left" >
<label >Tavsiye EdenLer *</label>
</td>
<td class="right" >
<input type="text" size="20" name="q13_TavsiyeEdenLer" class="text" value="" id="q13" maxlength="100" maxsize="100" />
</td>
</tr>
<tr >
<td width="150" class="left" >
<label >Yaşadıgın Şehir.</label>
</td>
<td class="right" >
<input type="text" size="20" name="q14_Yaadgnehir" class="text" value="" id="q14" maxlength="100" maxsize="100" />
</td>
</tr>
<tr >
<td width="150" class="left" valign="top" >
<label>Kendini Tanıt ( ZorunLu degildir. )</label>
</td>
<td class="right" >
<textarea cols="30" rows="2" name="q17_KendiniTantZorunLude" class="text" id="q17" ></textarea>
</td>
</tr>
<tr >
<td width="150" class="left" valign="top" >
<label>Sitemize Puan Verin</label>
</td>
<td valign="top">
<input type="hidden" name="q23_SitemizePuanVerin" id="q23" />
<table id="starTable_q23" width="75" border="0" cellpadding="0" cellspacing="0" style="background:url(http://jotform.com/images/star0.gif)" onmouseout="resetRate(this,'q23')">
<tr>
<td width="15" height="15" onmouseover="changeColor('1','starTable_q23')" onclick="rate(this,'1','q23')"></td>
<td width="15" onmouseover="changeColor('2','starTable_q23')" onclick="rate(this,'2','q23')"></td>
<td width="15" onmouseover="changeColor('3','starTable_q23')" onclick="rate(this,'3','q23')"></td>
<td width="15" onmouseover="changeColor('4','starTable_q23')" onclick="rate(this,'4','q23')"></td>
<td width="15" onmouseover="changeColor('5','starTable_q23')" onclick="rate(this,'5','q23')"></td>
</tr>
</table>
</td>
</tr>
<tr >
<td width="150" class="left" valign="top" >
<label>Yandaki Güvenlik Kodunu Giriniz.*</label>
</td>
<td valign="top">
<script type="text/javascript" src="http://jotform.com/captcha.php"></script> <input type="text" name="qCap" class="text" id="uword" />
</td>
</tr>
<tr >
<td width="150" class="left" >
</td>
<td class="right">
<input type="submit" class="btn" value="Gönder" /> <input type="reset" class="btn" value="Clear" />
</td>
</tr>
</table>
</div>
</div>
</form>
</td>
<td class="midright" width="10"> </td>
</tr>
<tr>
<td class="bottomleft" width="10" height="10"> </td>
<td class="bottommid"> </td>
<td class="bottomright" width="10" height="10"> </td>
</tr>
</table>
<script type="text/javascript">
validate("q_form_83251049752");
</script>
