DATA CUSTOMER

<script language="javascript" type="text/javascript"> function valform() { var str2 = document.conform.email.value; var re = /^[\w-]+(\.[\w-]+)*@([\w-]+\.)+[a-zA-Z]{2,7}$/; if (document.conform.nama.value == ""){ alert ("Tolong masukkan nama anda."); return false; } else if(document.conform.alamat.value == ""){ alert("Tolong masukkan alamat rumah anda."); } else if(document.conform.phone_rumah.value == ""){ alert("Tolong masukkan Telephone anda.."); return false; } else if(document.conform.email.value == ""){ alert("Tolong masukkan alamat email anda."); return false; } else if (!str2.match(re)) { alert ("Format alamat email salah."); return false; } else { return true; } } </script><br /> <strong>   FORM DATA CUSTOMER</strong><br /> <div style="float: left; margin-left: 10px; padding-top: 10px; width: 655px;"><br /> Silahkan mengisi form dibawah ini secara lengkap dan benar agar kami dapat menghubungi anda kembali untuk proses selanjutnya. <br /> <br /> <br /> <form action="mailto:andhika_zaputra@yahoo.com" enctype="text/plain" method="POST"><table border="0" cellpadding="0" cellspacing="0" style="width: 100%px;"><tbody> <tr> <td width="25%">Tipe Mobil<br /> <input id="hiddenField" name="hiddenField" type="hidden" value="order_id" /></td> <td width="2%">:</td> <td width="73%"><select> <br /> <option value="Evalia 1.5 ST M/T">Evalia 1.5 ST M/T</option> <br /> <option value="Evalia 1.5 SV M/T">Evalia 1.5 SV M/T</option> <br /> <option value="Evalia 1.5 SV A/T">Evalia 1.5 SV A/T</option> <br /> <option value="Evalia 1.5 XV M/T">Evalia 1.5 XV M/T</option> <br /> <option value="Evalia 1.5 XV A/T">Evalia 1.5 XV A/T</option> <br /> <option value="DATSUN GO+ D M/T">DATSUN GO+ D M/T</option> <br /> <option value="DATSUN GO+ A M/T">DATSUN GO+ A M/T</option><br /> <option value="DATSUN GO+ A OPTION M/T">DATSUN GO+ A OPTION M/T</option> <br /> <option value="DATSUN GO+ T M/T">DATSUN GO+ T M/T</option><br /> <option value="DATSUN GO+ T OPTION M/T">DATSUN GO+ T OPTION M/T</option><br /> <option value="DATSUN GO+ T STYLE M/T">DATSUN GO+ T STYLE M/T</option><br /> <option value="DATSUN GO A M/T">DATSUN GO A M/T</option><br /> <option value="DATSUN GO T M/T">DATSUN GO T M/T</option><br /> <option value="DATSUN GO T OPTION M/T">DATSUN GO T OPTION M/T</option> <br /> <option value="DATSUN GO T ACTIVE M/T">DATSUN GO T ACTIVE M/T</option> <br /> <option value="Grand Livina SV 1.5 M/T">Grand Livina SV 1.5 M/T</option> <br /> <option value="Grand Livina SV 1.5 A/T">Grand Livina SV 1.5 A/T</option> <br /> <option value="Grand Livina XV 1.5 M/T">Grand Livina XV 1.5 M/T</option> <br /> <option value="Grand Livina XV 1.5 A/T">Grand Livina XV 1.5 A/T</option> <br /> <option value="Grand Livina HWS 1.5 M/T">Grand Livina HWS 1.5 M/T</option><br /> <option value="Grand Livina HWS 1.5 A/T">Grand Livina HWS 1.5 A/T</option><br /> <option value="Grand Livina HWS AUTECH 1.5 A/T">Grand Livina HWS AUTECH 1.5 A/T</option> <br /> <option value="Grand Livina X-Gear 1.5 M/T">Grand Livina X-Gear 1.5 M/T</option> <br /> <option value="Grand Livina X-Gear 1.5 A/T">Grand Livina X-Gear 1.5 A/T</option> <br /> <option value="Juke Revolt 1.5">Juke Revolt 1.5</option><br /> <option value="Juke Revolt 1.5 Red Interior">Juke Revolt 1.5 Red Interior</option><br /> <option value="Juke RX 1.5">Juke RX 1.5</option> <br /> <option value="Juke RX 1.5 Red-interior">Juke RX 1.5 Red-interior</option> <br /> <option value="March 1.2 M/T">March 1.2 M/T</option> <br /> <option value="March 1.2 Middle A/T">March 1.2 Middle A/T</option> <br /> <option value="March 1.2 Upper A/T">March 1.2 Upper A/T</option> <br /> <option value="March 1.5 M/T">March 1.5 M/T</option> <br /> <option value="March 1.5 A/T">March 1.5 A/T</option> <br /> <option value="New Teana 2.5 A/T">New Teana 2.5 A/T</option> <br /> <option value="New Elgrand 2.5 HWS A/T">New Elgrand 2.5 HWS A/T</option> <br /> <option value="New Elgrand 2.5 HWS AUTECH A/T">New Elgrand 2.5 HWS AUTECH A/T</option> <br /> <option value="Navara NP300 SL M/T">Navara NP300 SL M/T</option> <br /> <option value="Navara NP300 VL M/T">Navara NP300 VL M/T</option><br /> <option value="Navara NP300 VL A/T">Navara NP300 VL A/T</option><br /> <option value="Serena - X A/T">Serena - X A/T</option> <br /> <option value="Serena HWS A/T">Serena HWS A/T</option> <br /> <option value="Serena HWS Panoramic Autech A/T">Serena HWS Panoramic Autech A/T</option><br /> <option value="X-Trail 2.0 M/T">X-Trail 2.0 M/T</option> <br /> <option value="X-Trail 2.0 CVT">X-Trail 2.0 CVT</option> <br /> <option value="X-Trail 2.5 CVT">X-Trail 2.5 CVT</option><br /> <option value="X-Trail 2.0 HYBRID">X-Trail 2.0 HYBRID</option> <br /> </select></td> </tr> <tr> <td>Nama</td> <td>:</td> <td><input class="form" id="nama" name="nama" size="25" type="text" />*</td> </tr> <tr> <td valign="top">Alamat </td> <td valign="top">:</td> <td valign="top"><textarea class="form" cols="40" id="alamat_rumah" name="alamat_rumah" rows="4">* Telephone : * Email : Rencana Pembelian : Tunai Kredit Harap diisi apabila anda memilih Rencana Pembelian Kredit Tenor Angsuran : 1 Tahun 2 Tahun 3 Tahun 4 Tahun 5 Tahun Down Payment (DP)    : Catatan :








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